The Doc Replies

Our expert answers your medical questions

I have horrendous bad breath but despite cleaning my teeth regularly, the problem persists. What can I do?

It is difficult to tell for yourself if you have bad breath and you would normally rely on a trusted family member or friend to tell you. However, if you are worrying about it, you can lick the inside of your wrist and if that is smelly once it dries, it gives you an indication of whether you have a problem.

Bad breath is normal in some circumstances, like when you first wake up in the morning, or after eating garlic or drinking alcohol.

Crash diets and fasting can cause bad breath because of a boost of ketones, as can some drugs such as diuretics, or forms of chemotherapy.

However, the most common cause is dental or oral hygiene.

So regular teeth cleaning, flossing and sometimes use of mouthwashes and tongue scrapers are useful.

You should limit sugary foods, alcohol and smoking.

There is usually nothing sinister behind bad breath.

I’m in my sixties and have a fairly healthy diet of lean meat and fish, vegetables, fruit and dairy. I’m wondering if I should also take vitamin supplements?

Overall, no.

Probably the only vitamin supplement you need to think about is vitamin D in the winter, and that is important with the lockdown for Covid-19, as people are in the house most of the time.

Most vitamin D is made by the action of sun on the skin and most people will not get enough in their diet. Consider taking 10 micrograms a day.

According to his GP, my son has a carbuncle on his shoulder. What causes it and how is it treated?

A furuncle – or a boil – is an infection of a hair follicle. A carbuncle is when a group of hair follicles are infected. It is like a multiple boil and it can be several centimetres in size.

Small ones might disappear by themselves.

A carbuncle can be eased by letting the pus out and this is done by a doctor or a practice nurse, but antibiotics may also be prescribed.

The Doc Replies

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