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by James Thomas, Saturday, 07 January 2017 | Categories: General Health

Dentists Unite against Antibiotic Resistance

If there’s one health-related topic that’s been consistently grabbing headlines in recent years it’s antibiotic resistance. Antibiotic resistance is a term referring to bacterial infections that can no longer be treated effectively with existing antibiotics. It’s a huge problem facing modern medicine because simple infections that are currently treated quickly and easily may soon become unmanageable. It’s a particular issue for patients undergoing serious medical treatments such as major surgery, chemotherapy or stem cell transplant; the advent of antibiotic resistance means the simplest of surgeries could become too risky to carry out.

For medical professionals, this growing problem has demanded fresh approaches to the use of antibiotics. Resistance develops through overuse and misuse – not finishing a course of antibiotics, for instance, can lead to small amounts of bacteria surviving and, in response to the specific treatment, developing a resistance.

It’s unsurprising, then, that medical bodies like the Faculty of General Dental Practice (FGDP), the British Dental Association and the Association of Clinical Oral Microbiologists are coming together to raise awareness of antibiotic misuse, and to audit the way dentists manage oral and dental infections.

According to Dentistry.co.uk, dental treatments account for 9% of all antibiotic use in the UK. By more rigorously auditing the way in which antibiotics are prescribed for dental issues, it is hoped that we will see a decline in misuse. Bodies like the FGDP currently offer guidance for how antibiotics should be prescribed, however, going forward, British dentists are keen to do more.

One tactic is to spend more time explaining treatments to patients. It’s hoped that, with some more guidance from their dentist, patients who are prescribed antibiotics will start taking them more responsibly.

In essence, it all comes down to education, which is why we’ve pulled together a short guide to common dental issues, and how you can treat them safely – without contributing to the resistance crisis.

Common Dental Problems

A common marker of a dental problem is toothache, which occurs when the tissue at the centre of a tooth becomes inflamed. Because some of the causes of toothache can be fairly serious, it’s important to visit a dentist if the pain doesn’t go away on its own after one or two days – particularly if it is very severe.

Causes of toothache include:

  • Tooth decay, in which acid caused by plaque build-up attacks your teeth leading to cavities, or in worse cases gum disease or abscesses
  • A cracked tooth
  • A broken or loose filling
  • Receding gums, in which the gums shrink away, exposing the more sensitive parts of the tooth
  • Periapical abscess, in which a bacterial infection causes pus to collect at the end of the tooth

Oral pain that is not strictly defined as toothache (because it does not stem from the centre of the tooth) can be caused by:

  • Periodontal abscess, in which a bacterial infection causes pus to collect in the gums
  • Sinusitis
  • Ulcers on the gums
  • Soreness around a tooth about to break through (for adults, this typically happens with wisdom teeth)

Treatments for Dental Pain

You may think that dental discomfort caused by a bacterial infection would be automatically treated with antibiotics; however, this isn’t the case. In fact, antibiotics should typically only be prescribed in emergency situations when the infection is very severe.

Usually, dental issues such as those described above should be tackled with a combination of dental procedures (for abscesses, this can involve a root canal or tooth extraction) and lifestyle changes. The current NHS guidance on dental health recommends the following:

  • Brushing your teeth with fluoride toothpaste for two minutes, at least two times a day
  • Using floss or an interdental brush once a day to clean between teeth and around the gum line
  • Reducing your intake of sugary or starchy foods and drinks
  • Visiting your dentist regularly

More guidance on good dental hygiene can be found at The Oral Health Foundation.

In the case of a severe dental abscess, The Online Clinic can prescribe emergency antibiotics. This is a good option if you cannot get access to your dentist. Click here to visit our online dental clinic and learn more.

by James Thomas, Saturday, 05 November 2016 | Categories: General Health

It’s a feeling nearly everyone can relate to; you’ve just eaten a delicious meal at a posh restaurant and when you get home to bed, you find yourself clutching your chest and gulping down water to try and alleviate that horrible burning sensation.

No, you’re not having a heart attack – but heartburn (which is caused by stomach acid leaking into the oesophagus) is certainly an unpleasant thing to experience. And you’d be in the minority if you haven’t been through it at least once in your life. Unfortunately, for some Brits, heartburn is a daily reality, just one symptom of a chronic condition known as gastro-oesophageal reflux disease (or GORD, for short).

In 2011, a Norwegian study found that cases of GORD were on the rise, and suggested a link between this and rising body weights. At the time, the Daily Mail reported on this study, interpreting the results as an indication that obesity caused by a fatty diet is a direct cause of heartburn and acid reflux. As shown here, the NHS dismissed the Daily Mail’s take on the results, as the study did not show a link between diet and symptoms.

In fact, while it is true that obesity puts you at greater risk of GORD the foods that most commonly cause heartburn are not those you might expect. According to the experts at WebMD, some of our favourite healthy foods can be a high risk for triggering an attack of heartburn.

If you find yourself regularly battling with heartburn, it’s worth visiting a doctor, as you may be suffering from GORD and may require medication. If you aren’t diagnosed with GORD, or if it’s only causing moderate symptoms, you should be able to manage the condition at home by making some adjustments to your diet and lifestyle.

Foods to Avoid

There are a number of different foods and drinks that can trigger heartburn and acid reflux:

  • Acidic foods such as citrus fruits or juices, and tomatoes
  • Garlic and onion
  • Spicy food containing lots of pepper and/or chilli
  • Peppermint
  • Alcohol
  • Caffeine
  • Chocolate
  • Carbonated drinks

Though the Daily Mail’s condemnation of a fatty diet was a little slapdash, they weren’t totally wrong – as you’ll read here, foods that are high in fat (avocado, cheese, nuts and steak) can also cause heartburn. This is because high-fat foods cause the stomach to empty more slowly, meaning it is more likely to swell, putting pressure on the muscles that keep it closed and allowing for acid to leak out.

Having said that, it may not be necessary to completely cut out the foods and drinks listed above – particularly the healthier ones. However, eating them in moderation, and not in combination with one another, is advised.

Lifestyle Changes

As well as looking out for foods that can trigger your heartburn, you should avoid eating very large meals – instead, eat several small, light meals over the course of the day, and leave several hours between dining or drinking alcohol and going to bed.

Raising the head of your bed by around 20cm can also help to alleviate symptoms. This is because, for stomach acid to leak into the oesophagus, you have to be lying flat or bending over. Lying at an angle should help prevent this from happening. To raise your bed you should insert blocks underneath the bed – simply propping yourself up with pillows will not work.

Losing weight and quitting smoking are also advised.

Medical Treatment for Heartburn

If you are suffering from persistent heartburn, it may be appropriate to start using medication. There are various types available, ranging from over-the-counter antacids to prescription-only proton-pump inhibitors (PPIs) and H2-receptor antagonists (H2RAs). Antacids neutralise the effects of stomach acid, while PPIs and H2RAs actively reduce the amount of acid produced by your stomach.

In rare cases, surgery may be the most suitable course of action. Most commonly, GORD is resolved through keyhole surgery in which the ring of muscle between the oesophagus and the stomach is tightened. This prevents the leakage of stomach acid.

To find out more about medical treatments for heartburn, consult our dedicated heartburn page.

by James Thomas, Saturday, 15 October 2016 | Categories: General Health

For many people, there’s something irresistible about the idea of a midnight snack or a movie night packed with popcorn and sweet treats. But though we all know indulging in biscuits, brownies and crisps is bad for our health at any time of day, how many of us are aware of the toll these foods can take when they’re eaten after 7pm?

If recent findings are to be believed, then we all need to start making our evening binges a thing of the past. As reported here, the European Society of Cardiology has found that people who eat large meals after 7pm experience dramatic increases of blood pressure overnight.

This is worrying because high blood pressure (also known as hypertension) is associated with all kinds of health issues, including heart disease and stroke. It’s also concerning because most of us consider 7pm an ideal time to eat dinner!

If the research is accurate, and eating late really can cause problems with our blood pressure, then what is the best way to stay healthy? Well, it isn’t as simple as eating dinner at 6.30pm.

Current Guidance for Healthy Eating

According to the NHS, there are several factors that go into a healthy diet. The first recommendation is that men consume 2,500 calories and women 2,000 calories a day. This will differ slightly depending upon your age, fitness, health and weight. However, if you get into the habit of eating significantly more or less than this, you could be putting your health at risk.

The calories you consume should also be nutritious, and not simply made up of sweets and junk food. Your daily diet should include:

  • 5 portions of fruits and vegetables
  • Starchy carbohydrates, preferably wholegrain or high fibre
  • Protein in the form of lean meat, fish, eggs, pulses and/or beans
  • Low fat dairy
  • 6 to 8 glasses of water

Red meat should not be eaten too regularly; however, in small portions it does have health benefits, as it is packed with protein, iron and zinc. If you are eating more than 90g a day you are advised to cut down.

Sugary drinks, chocolate, sweets and snack foods that are oily, fatty or salty are not strictly off-limits. However, they should be restricted; eat this kind of junk food in small portions, and not on a regular basis.

The newest research also suggests that eating at the same time every day is also important. Heart expert Dr Ebru Özpelit advises that we should eat a good breakfast, avoid skipping lunch, and keep our evening meal small, light, and ideally before 7pm.

Avoiding High Blood Pressure

It’s not always easy to avoid developing high blood pressure. This is because it is related to age, genetics and family history, and even sleep deprivation.

If you think you may be at risk of high blood pressure, you should visit your doctor for a blood pressure test. A normal blood pressure measurement is anything between 90/60mmHg and 120/80mmHg. High blood pressure is considered anything over 140/90mmHg. However blood pressure between 120/80mmHg and 140/90mmHg is considered prehypertension – this means your blood pressure could continue to rise and pose a risk to your health. If your blood pressure is in this range, you may wish to start making some changes to your diet and lifestyle.

Things you can do to limit your risk of (or lower existing) high blood pressure include:

  • Eating less than 6g of salt a day (roughly one teaspoon)
  • Cutting down your alcohol intake, and avoiding alcohol "binges"
  • Losing weight
  • Exercising (the NHS recommends at least 150 minutes of moderate activity every week)
  • Cutting down on caffeine
  • Quitting smoking
  • Getting a good night’s sleep

In some cases, this won’t be sufficient, and medication will be required.

Medical Treatments for High Blood Pressure

There are several different treatments for high blood pressure. The five most common are:

These medications are prescribed depending upon your age, health and family history. Find out more about pursuing a healthy lifestyle and avoiding high blood pressure by visiting The Online Clinic’s hypertension information page.

by James Thomas, Saturday, 10 September 2016 | Categories: General Health

Who handles pain better, women or men? This simple question is hotly debated in the medical community and, indeed, many social circles. There’s the argument that women naturally handle pain better, because they have to experience menstrual cramps and childbirth. This is fairly convincing until you consider the fact that in a recent study of 11,000 patients, women were consistently found to have elevated clinical pain scores in comparison to men.

Pain is, of course, a totally subjective thing, and there are many different factors that must be called into account when examining the way one person handles it. A man may understate the severity of his pain in an attempt to seem more masculine. Two women may experience the same injury, but experience it differently due to one of them living with a pre-existing condition that causes chronic pain.

What is undeniable is that, for doctors, fairly evaluating a patient’s pain level is no easy task. And if recent reports are anything to go by, this is leading to unfair treatment of female patients. According to research carried out over the past few years, women’s pain is – by and large – taken less seriously than men’s. Abdominal pain is just one instance where men and women are treated very differently, with men waiting an average of 49 minutes in A&E and women an average of 65 minutes.

Some may argue that doctors are more likely to downplay abdominal pain in women, because they make the assumption it is related to menstrual cramps (which are agonising but otherwise harmless). But in this worrying story penned by journalist Joe Fassler, we see an example of a potentially life-threatening condition ignored by hospital doctors and nurses for many hours. Recently, coverage of endometriosis – a condition in which cells similar to those in the womb lining grow outside of the uterus – has also revealed how women suffering with this debilitating condition are often dismissed by doctors.

Regardless of what pain may indicate, it’s important as a patient to feel as though your suffering is acknowledged and understood. The question is: how should women go about seeking medical help for pain when doctors are more likely to dismiss it?

What to Do If You’re Experiencing Pain

The hard and fast rule for any health-related issue is to trust your instincts. If you begin to experience pain that you have never felt before and that doesn’t go away on its own, it is always worth seeking medical help.

There are also certain symptoms that, according to medical advice, should never be ignored. These include:

  • A sudden, severe headache, especially if it is accompanied by visual aura. This could indicate a number of acute conditions that require immediate medical attention.
  • Bad toothache where the tooth throbs or twinges. If left untreated, a damaged nerve can become infected, and this infection can spread through the body causing serious complications.
  • Severe, stabbing abdominal pain that travels to your lower right-hand side and becomes worse as time goes on. This could indicate appendicitis, but it could also be a sign of an ovarian cyst. In either case, do not ignore the pain.
  • Constant back pain and numb feet. This is an indication of a problem in the spine, caused by a spinal disc slipping or rupturing and pressing on the spinal nerves.
  • Chest pain, shortness of breath and a feeling of tightness or pressure in the chest. This can indicate a heart attack.

Living with Chronic Pain

In some cases, pain is not something that requires urgent medical treatment. For people who suffer from conditions that cause chronic pain, it’s simply a part of everyday life.

There are many different ways of managing chronic pain, but some things that are known to help include exercise, physical therapy and painkillers. The psychological aspect of chronic pain can also be very damaging; for that reason, it’s advised that you try and live as normal a lifestyle as possible. Staying in work, continuing to see friends, and making sure you leave the house every day are all key to maintaining a positive outlook.

The NHS has further resources dedicated to living with pain, which you can explore here. Otherwise, speak to your GP or visit The Online Clinic’s Pain Management centre, where you can learn more about managing pain and request safe prescription painkillers.

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by James Thomas, Wednesday, 20 July 2016 | Categories: General Health

Listen Up: Tips for Ear Health!

Our ears are incredibly important to our everyday lives yet caring for their health often seems to be little more than an afterthought for many people. The good news is that it is not difficult to take a little extra time to make sure you are caring for your ears in the correct manner.

Cleaning ears

It is important that you take extra special care when you are cleaning your ears. You should use a tissue or a gentle washcloth to wipe the outside of the ear, and nothing smaller than an elbow should be placed inside your ear! Cotton buds or any kind of pointed, sharp object should not be used to clean out your ears as they can injure the eardrum or ear canal.

The ear has its own mechanism for cleaning itself in the form of ear wax but if your hearing is being blocked by a wax build-up then you should see your doctor in order to have it professionally removed. If your ears begin hurting or itching go to your doctor to find the best treatment method; you may need to be referred to a specialist in some situations. People with pierced ears should regularly use rubbing alcohol to clean both the earrings and their earlobes.

Illnesses and medicines

Ears can suffer illnesses and infections just like any other part of the human anatomy, and need to be treated by a health professional. Treating infections of the upper respiratory system in a prompt manner, however, can help with cutting down on the risk of developing an ear infection.

There are a number of medical conditions and illnesses that can have an impact on your hearing, so see your doctor immediately if you suddenly experience a loss of hearing or endure a constant noise in your head or ears. Ear drainage is abnormal and often indicative of some kind of infection, so consult a healthcare professional as soon as you can.

Hearing can also be affected by some medicines, so be sure to take them only as directed and visit your GP if you are experiencing ringing in the ears, balance problems or any kind of unusual hearing.

Noise issues

If you are going to be exposed to loud noise levels at work or at home, such as when using power tools, a lawn mower or leaf blower, then you need to wear protection. Noisy work environments require hearing protection by law. Hearing is not protected by the use of ear buds and it can actually be dangerous to your hearing to listen to music while using power tools. High volume levels should also be avoided with home theatre systems, stereos and any kind of personal sound system. If you are going out to a motor sport event, nightclub or rock concert, you should wear earplugs.


If you engage in activities that put your head and ears at risk of injury, such as biking, skiing or rollerblading, you should always make sure to wear a helmet. If you're taking a flight, then you should yawn and swallow continually when the plane is in ascent or descent in order to equalise the pressure in your ears. If you have a sinus infection or cold, then you can consume a decongestant a couple of hours prior to descent or make use of a decongestant spray before descent and landing.

General ear care tips

Your doctor should give your ears a check-up on a regular basis. A sunscreen needs to be used on your ears in sunny weather as it does with any other exposed area of your body. Consult a doctor if you find any scaly areas or strange bumps on the exterior of your ear.

Finally, it is also a good idea to be aware of some things that can be warning signs for hearing loss; these include:

  • Difficulty in hearing conversations, particularly when there is background noise
  • Misunderstanding other people and making inappropriate responses
  • Needing the television to be louder than is preferred by others in the room
  • Noise within the ear not the result of external sources

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