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Monthly Archives: October 2017

Oral Health: A Window To Your Overall Health

Very few people enjoy trips to the dentist. How often do you hear someone declare that they can’t wait to go for their regular tooth cleaning?  The grinding, the chipping away with sharp instruments, and the polishing is enough to make most squirm just reading this.  But, while the experience may be unpleasant, it is extremely important to get regular dental checkups and to maintain overall oral health.

                While we often think of oral health issues as being isolated to the mouth and teeth, oral health and total overall health are linked.  Poor oral hygiene can, of course, lead to issues such as tooth decay and gum disease.  However, it can also result in cardiovascular disease, endocarditis, and potentially premature birth.  Conversely, common disease states such as diabetes and osteoporosis can cause oral health issues.  Additionally, some common medications such as antihistamines, diuretics, and decongestants can have a negative impact on oral health factors such as saliva production.  Therefore it is important to maintain good oral hygiene for both healthy and unhealthy individuals.

So what preventative steps can we take to maintain oral health?  Well the first should be easy, as all of us learned it from the time we were toddlers.  Brushing at least twice a day helps to remove acid build up on the teeth from the breakdown of food, thus preserving the protective enamel that coats the teeth.  Brush thoroughly, being sure to contact all surfaces of the teeth.  If brushing after each meal isn’t always possible, rinse your mouth with water after eating to help wash away food particles.  And while recent research has called into question the benefits of flossing, it is certainly not harmful to floss at least once a day to provide an even more thorough cleaning.

Much like all other aspects of health, what we ingest plays a large role in oral health.  Tobacco usage has a large negative impact on dental health and should be avoided.  Likewise, high sugar containing beverages like soda and juices should be limited, as sugar can wear on the enamel of the teeth.  Additionally, obtaining the right amount of calcium in the diet is essential as that can help to strengthen the teeth.

Finally, bite the bullet and see your dentist regularly.  Not only are routine checkups great for maintaining hygiene, but they can also spot issues such as cavities early before they become difficult (and expensive!) to treat.  Visit the dentist at least twice per year, and whenever toothaches or jaw pain appears.

While we often think oral health issues are limited to being treated in the dentist’s office, and many are, such as cavities and root canals, as a pharmacist, I often treat patients experiencing some difficult conditions related to the oral cavity.

One of the most common complaints patients present to us with in the community pharmacy is dry mouth.  This can be the result of many different factors such as medication, other disease states, or improper diet.  Obviously staying properly hydrated is a key factor to treatment in this arena, but sometimes, that is not enough.  In those cases, patients can benefit from over the counter products that help to increase mouth lubrication, such as Lubricity™, a topical spray used after each meal.  For patients with extremely difficult to treat dry mouth, medications which enhance salivary production, such as pilocarpine, can be made in special dosage forms like lozenges or lollipops. By sucking on the lozenge or lollipop, the patient gets an increase in saliva production while avoiding side effects in the rest of the body from the drug.

Another condition we see quite often in our practice is patients with oral lesions.  These sores, such as canker sores, can be extremely painful, and interfere greatly with quality of life.  These conditions can result from a variety of factors, be it stress, diet, or other illnesses, and can be stubborn to treat.  Some of the best treatments for these are oral medicated mouth rinses which combine multiple drug classes, such as steroids, antibiotics, antifungals, and anesthetics, into one rinse. These rinses often go by names such as “Rothwell’s” or “Magic Mouthwash”, and are swished around in the mouth regularly throughout the day to coat the sores, and help to both soothe irritation and speed healing.

Finally another condition we sometimes see is “burning mouth syndrome”.  Burning mouth is just what it sounds like in that it often causes a strong tingling or burning sensation throughout the mouth.  This sensation is often felt on a consistent basis and can be quite difficult to deal with.  Many patients experiencing this may benefit from over the counter supplements like lipoic acid which may help to alleviate the nerve sensation.  For those patients with difficult to treat instances of burning mouth, medications such as clonazepam and capsaicin can be made into mouth rinses or lozenges.  By placing these medications in the mouth, the overactive nerves causing the burning are in effect numbed out, and the patient achieves relief.

These types of specialty medications and supplements listed above are generally found at pharmacies which specialize in vitamin supplementation and the art of compounding, such as Pine Pharmacy in Williamsville.

Following proper oral hygiene and having any dental issues addressed in a timely fashion is a great way to keep your mouth clean and healthy, and stop it from affecting other aspects of your health.  Don’t ignore it, or else you will find yourself regularly in the dentist’s chair, and paying a lot of hefty dental bills.  Remember, there is a reason root canals are often used as a metaphor for some of the most unpleasant things in life, so do your best to prevent them!

Women’s Health

 

Hot flashes, night sweats, mood swings, insomnia…sounds like a nightmare doesn’t it? Unfortunately though, fifty percent of the people reading this article will like experience these symptoms in their lifetimes, and possibly a few more.  Of course, I’m referring to women experiencing the effects of hormonal changes in the body, be it premenstrual, pregnancy related, or menopausal, although for those women currently experiencing them, they might argue that nightmare sums it up much better.

Women’s health is a wide ranging topic.  While many men often complain that women are hard to understand, it is for good reason! A woman’s body is complex, undergoing many changes throughout life.  In fact, even in health conditions that afflict both men and women, women often have different outcomes and risks than men do.

So naturally, the question is what steps can be taken to minimize women’s health risks and what treatment options are available for the common conditions afflicting women? First there are the obvious answers. See your doctor yearly to get regularly scheduled checks such as Pap smears, reduce stress as much as possible, exercise regularly, and maintain a well-balanced healthy diet.

However, rather than rehash what most women already know they should be doing, I’d like to address some of the more common conditions and complaints I get from women as a practicing pharmacist.

By far and away the most troubling condition for women in my practice is menopause and perimenopause, the period immediately preceding menopause when hormone levels initially begin to decline.  The decline, and ultimate discontinuation, of hormone production by the ovaries can lead to a host of symptoms that can wreak havoc on a woman’s quality of life.  In addition to the hot flashes, insomnia, and mood swings, woman can also experience weight gain, decrease or loss of libido, vaginal dryness, and memory loss.

To combat this, there are a few tools at our disposal. First there are over the counter supplements that can help in certain cases.  For instance, rhubarb root extract, sold under the trade name of Estrovera®, is a great option to reduce hot flashes, one of the biggest complaints of menopause.  This non-hormonal herbal extract has been used in Europe for over twenty years, and has shown in clinical studies to have comparable results to low dose hormone therapy.  Other over the counter options that help to manage menopausal symptoms include evening primrose oil and black cohosh.  Additionally, cortisol, our body’s hormone that helps us to manage stress, is often disrupted by the hormonal changes menopause presents, leading to issues such as weight gain, fatigue, and potentially hot flashes. Adaptogenic herbs such as eleuthero, ashwaganda and rhodiola rosea, commonly sold in combinations products like Adrenotone®, are highly effective at helping the body normalize cortisol levels, thus relieving these symptoms.

In the prescription realm, hormone replacement therapy (HRT) is another option to combat the symptoms of menopause. This type of therapy is highly individualized, as each woman’s hormone deficiencies and imbalances are different.  For instance, while one woman may need estrogen, another may have too much estrogen already in their body and need progesterone to balance that excess.  When customized properly to the individual’s needs and symptoms, the results can provide drastic improvements in quality of life.  Additionally, while you may have heard of risks associated with HRT such as breast cancer and cardiovascular events, when the dosages and hormones of HRT are customized to each individual by a physician and pharmacist well trained and experienced in the field of HRT, the risks can be greatly minimized by administering the proper combinations in the proper dosage forms.

A main distinction in hormone replacement therapy is non bio-identical hormones, such as medroxyprogesterone and conjugated equine estrogens, versus bio-identical hormones such as progesterone and estrogens like estriol and estradiol.  The main difference between the two is that a bio-identical hormone’s chemical structure matches exactly to the hormones you already have circulating in your blood.  In other words, giving your body a bio-identical­ hormone is giving it something it expects to have, and has had your entire life.  Conversely, non bio-identical hormones vary in their structure and function from the natural hormones you have in your body, and your body does not have receptors designed to receive those hormones.  In essence, taking a non bio-identical hormone is like fitting a square peg into a round hole.  As you might expect, medical literature and data has demonstrated that using a bio-identical hormone tends to be more effective and have a better safety profile long term as compared to a non bio-identical hormone.

While menopausal issues are significant, there are many other women’s health issues that I see in my practice. For instance, many young women experience trouble with premenstrual syndrome and the symptoms associated with it.  While prescription drugs such as birth control can be effective at controlling those issues, over the counter supplements that contain herbs like chaste tree berry, wild yam root, and passionflower, are great options to support PMS naturally.

Additionally, there are often concerns about what constitutes a good prenatal vitamin. Generally, you want to look for a prenatal vitamin that is comprehensive and provides an adequate amount of folate, preferably as methlyfolate, a readily active and utilized form in the body, as compared to folic acid which must be converted to the active form in the body and is done so poorly in some women who have certain genetic mutations.  Additionally, look for a product that gives you a good amount of DHA, an omega-3 that supports healthy brain development in your baby.  Try to get at least 400 to 500mg of DHA per day while pregnant or nursing.

Finding the right healthcare professional to address your health is essential. Women are complex and sophisticated, and their health is no different. Seek out physicians and pharmacists that specialize in women’s health and have experience in the field.  Compounding pharmacies such as Pine Pharmacy in Williamsville are great resources for both hormone replacement and vitamin supplementation to support a woman’s health from youth through the golden years.