Q: Teeth whitening is now very popular. I certainly would like my teeth to look whiter, but I want to know if there are risks to one’s health from using a tooth-whitening kit. If so, it would be preferable to not have bright, shining teeth!
A: There are a number of options for making teeth whiter. The dentist can perform the bleaching procedure in the office or provide kits to use at home. You also can buy whitening strips over the counter. All such products work through hydrogen peroxide. What differs is the concentration.
It makes sense to check with your dentist first before you use a bleaching product. They have the potential to cause tooth sensitivity, for which the dentist can recommend sensitivity-reducing toothpaste. If a tooth has a crack or a cavity, applying the bleaching product could result in significant pain.
Whiteners only work on natural teeth, not on caps, crowns or fillings. After bleaching, the teeth are more susceptible to re-staining, so wait several days before eating or drinking anything dark, such as wine, tea, coffee, blueberries or chocolate. Provided you don’t bleach too frequently (probably not more than twice a year), such products seem safe and effective.
Q: I have read that people over 60 don’t need to take blood-pressure medicine unless their numbers go over 150/90. It appears that getting pressure below 140/90 can require high doses of blood-pressure drugs or multiple medications that may cause side effects.
I myself am in that age category and am taking amlodipine. My knees are swollen and hurt a lot when I walk. I often feel dizzy and tired.
My blood pressure runs about 140/60. How can I stop taking this drug?
A: New guidelines published in JAMA (Feb. 5, 2014) confirm that when blood pressure is below 150/90, drug treatment is not necessary for those over 60. If your medicine is making it hard to walk or exercise, ask your doctor if you can try other ways to control hypertension.
To help with that discussion, we are sending you our Guide to Blood Pressure Treatment with many nondrug approaches. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (70 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. B-67, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharmacy.com.
Q: Your discussion of prednisone side effects is lacking an important one. I have seen no mention of AVN (avascular necrosis), a serious consequence of this drug.
I was on prednisone for supposedly “short-term low-dose” therapy, which turned out to be neither. I developed AVN two years after I stopped taking it. As a result, I lost my hip at age 58.
The package insert states that prednisone can cause this horrible condition. I was in excruciating pain in a wheelchair for two years before I finally had a hip replacement.
Doctors prescribe this medication too casually for non-life-threatening problems.
A: Avascular necrosis results from loss of blood supply to bones, resulting in tissue death. The hip is especially susceptible and often needs to be replaced when this occurs.
Conventional wisdom is that this complication only occurs after high doses of corticosteroids for long periods of time. There are, however, cases in the medical literature similar to yours (Clinical Orthopaedics and Related Research, June 1992; BMJ, June 30, 2001).
In their column, Joe and Teresa Graedon answer letters from readers. Write to them via their website at www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”
