Dr. Swiner’s Q&A

Question and answer time
Published Wednesday, March 5, 2014

by C. Nicole Swiner, M.D., Columnist

Here are some recent questions from my Facebook page.

Q: How can dental problems impact physical health? – JRB, mother of two

A: Tooth health, and lack thereof, can lead to and be a clue to many health problems. Issues such as oral ulcers, gum disease, gingivitis, bleeding gums and tooth loss can indicate diabetes, cancers, vitamin deficiencies and sexually transmitted diseases. It’s as important to have your dental checkups every six months as it is to have your physical exams annually, as dental and medical health go hand in hand. 


Q: How do we know when it’s time to get glasses for general vision and not just reading glasses – JRB

A: Seeing your optometrist or ophthalmologist every one to two years, particularly after age 40, is the best way to know. They are the best at performing very specific eye exams and letting you know if you need prescription glasses. However, if you have other symptoms such as seeing spots, floaters, flashes of light or a blacking out of your vision, it could be a sign of medical disease. Conditions such as high blood pressure and high blood sugar can cause visual disturbances that your medical doctor should be aware of. 


Q: What are standard tests you should always get when you have hypertension, diabetes and/or high cholesterol? – JS, diabetic

A: Beginning at age 30, or earlier if I am suspicious, I test all patients during their regular or annual physicals for high blood pressure, glucose and cholesterol. If their labs are normal, they can skip a couple of years. At age 40, I check these baseline levels every year and more often if they have a significant family history, are obese, or levels have been abnormal in the past. With the unfortunate rise of childhood and adolescent obesity and associated health problems, I’ve been testing children at younger ages if I’m suspicious given their weight or family history. 


Q: Cold vs. allergies? How do you know the difference? How long should you wait to see a doctor? – JS

A: It can be difficult to tell the difference. The rule of thumb is this: A “cold” or viral infection generally lasts seven to 14 days. Allergies last weeks to months off and on. Allergies do not occur with fever, but can have almost any other symptom that goes along with a viral infection, such as fatigue, headache, sinus pressure, runny nose or chronic cough. 

Another million-dollar question is “Does green mucus mean I have an infection?” Yes and no. It could mean an infection, but it doesn’t mean it’s bacterial. It is a sign of white blood cells fighting something, and that something could be an allergy or a virus. A bacterial sinus infection is when one-sided facial pain, runny nose, fatigue, congestion, tooth pain and sneezing begin, and is prolonged. Talk to your doctor about concerning symptoms. 


Q: Doc, can you talk about probiotics, the benefits of maintaining a healthy balance and how to do so? – TB, mother of two

A: Probiotics such as Lactobacillus Acidophillus, Bifidus or the like, have been hailed as the miracle bacteria for conditions such as chronic yeast infections, bacterial vaginitis, diarrhea, IBS and other pH imbalance situations. There are no proven studies yet nor a “right” amount to take, but much research is being done on the benefits of these supplements. I love them for the above-noted conditions, and talk to my patients about taking them orally over the counter for prevention, or eating yogurt daily. Other than some possible GI discomfort, there aren’t any significant side effects either, so why not try it. 

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