What Does the Doctor Think? - March

WHAT DOES THE DOCTOR THINK THIS MONTH?

In General Practice, we see many patients who suffer from recurrent mouth ulcers. Often, having carefully investigated the patient to exclude local trauma and the wide range of infections and diseases with which mouth ulcers are associated, and having prescribed Corlan pellets and mouthwashes, we are, so to speak, up a gum tree if the patient continues to complain of mouth ulcers. A very frustrating situation for both patient and doctor!

I was interested to see an article in a newspaper about the widespread presence of Sodium Lauryl Sulphate (SLS) in toothpaste and cosmetics so I researched the matter. Sodium lauryl sulphate  is used as a detergent and is present in many cleaning and laundry products. It is also a very powerful  engine degreaser and it is also found in floor cleaners and car wash soaps. It is also used in biological tissue samples to dissolve cells, disrupting bonds within the proteins and denaturing the cells. It is the main ingredient in many shop-bought house fly killers.

Because of its ability to create a lather (it has thickening effects), it is also found in toothpastes, shampoos, bubble bath and shaving cream, lipsticks, hair sprays, sunscreens and lotions.  There have been many studies on how SLS causes mouth ulcers and, having looked at many of them, I am convinced that there is enough evidence to cause concern.

In toothpaste, SLS is used as a wetting agent, allowing the paste to spread more easily and stopping the components separating in the tube. It is present in about 85% of toothpastes so, if you are troubled by mouth ulcers, you might wish to use one of the following SLS-free products:

Lavera Sensitive Fluoride Toothpaste (soorganic.com)                                             £4.45

Sensodyne Pro-Namel (Boots, Lloyds)                                                             £3.00 - £4.40

BOCA (Botanical Oral Care Advantage) from boca.co.uk                                        £29.00!

Jason Powersmile Anti-Cavity and Tartar Control tooth gel (naturismo.com)               £5.79

Aldi's Dentitex own brand toothpaste                                                                           £0.70p

Waitrose own label “Total Care” toothpaste                                                                 £0.79p

Obviously, others will be available if you look for them.

I have also prepared a much more detailed article than this, with references, and I would be happy to send you a copy if you let me know.

Susan, a girl who had a glass eye, lived in a block of flats. One day, she was looking over her balcony when her glass eye fell from her eye socket and hurtled towards the ground. Ten floors below, John was looking out from his balcony, saw the eye falling and caught it. He looked up, she looked down and their three eyes met. She shouted down her flat number and John took the lift up ten floors and knocked on her door. She was mightily pleased, gave him a wonderful meal and a most pleasurable evening after which John asked her if she was so lovely to all the men she met. “Oh no” she said “only to those who catch my eye!”

A wife's confession to a friend: “I was looking for my keys. They were not in my pockets. A quick search in the meeting room revealed nothing.  Suddenly I realised I must have left them in the car.  Frantically, I headed for the car park. My husband has scolded me many times for leaving the keys in the ignition. My theory is the ignition is the best place not to lose them. His theory is that the car will be stolen.  As I scanned the car park I came to a terrifying conclusion! His theory was right. The car park was empty. I immediately called the police. I gave them my location, confessed that I had left my keys in the car, and that it had been stolen. Then I made the most difficult call of all.”

"Hello My Love", I stammered; I always call him "My Love" in times like these. "I left my keys in the car, and it has been stolen." There was a period of silence. I thought the call had disconnected, but thenI heard his voice. He barked, "I dropped you off!"

Now it was my time to be silent. Embarrassed, I said, "Well, come and get me." He retorted, "I will, as soon as I convince this policeman I have not stolen your bl**dy car."

It reminds me of the time Management and I went shopping in Cambridge. We returned to the car park and spent 20 minutes searching for my car. Eventually, just as we concluded it must have been stolen, I remembered that we had come in Deannie's car as mine was being serviced!

Best wishes to you all      Ian Nisbet