Asbury Park Press

Can some toothpaste­s make canker sores worse?

- The People’s Pharmacy Joe Graedon and Teresa Graedon Write to Joe and Teresa Graedon in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website: www.PeoplesPha­rmacy.com.

My father and I have both suffered with canker sores all our lives. I’ve heard of eating kiwi fruit to speed healing, and in a recent column, you wrote about sauerkraut.

A few years ago, a dental hygienist told me that canker sores are caused by sensitivit­y to sodium lauryl sulfate, a foaming agent present in many but not all toothpaste­s. Since I changed toothpaste­s, I have dramatical­ly fewer canker sores. Even when I bite the inside of my mouth, the sore spot clears within a day instead of the two weeks it used to take. SLS-free toothpaste has made my life more pleasant.

You are not the only reader who has told us that avoiding sodium lauryl sulfate (SLS) reduces the likelihood of canker sores. There is surprising­ly little research addressing this topic, given that so many products contain this foaming agent.

One systematic review in the Journal of Oral Pathology & Medicine (May 2019) of the medical literature concluded that use of SLS-free toothpaste­s helped control aphthous ulcers (canker sores).

What’s your assessment of the value of lithium to prevent dementia?

There have long been hints that lithium might be valuable to reduce the risk for dementia (Progress in NeuroPsych­opharmacol­ogy & Biological Psychiatry, Aug. 30, 2006). However, most research has focused on anti-amyloid drugs such as aducanumab (Aduhelm) or lecanemab (Leqembi). A systematic review turned up a number of animal studies but only a few clinical trials of lithium for preventing dementia (Ageing Research Reviews, March 2024).

Doses studied vary widely. When lithium is prescribed for bipolar disorder, doses range from 600 to 1,800 milligrams daily. Adverse effects may include diarrhea, muscle weakness, drowsiness, changes in thyroid function and kidney damage.

Much lower doses (10 to 20 milligrams of lithium orotate or citrate) have been used experiment­ally against depression and dementia. The risks may be reduced at such doses. Much more research is needed on this possible treatment.

I am aware that OTC pain relievers have side effects. However, two different orthopedic surgeons and a sports medicine doctor have all downplayed the risk of ibuprofen and/or naproxen. They recommend that I take one or the other daily for pain and swelling in my knee or hip.

The sports medicine doctor was openly hostile when I said I wouldn’t take ibuprofen as often as he recommende­d because I am concerned about the health of my kidneys. My two older siblings, who both have had knee replacemen­ts, have been advised by their primary care physicians that they can no longer take ANY ibuprofen because of reduced kidney function. Another sibling who worked at a kidney center saw first-hand the horrible things that happen when your kidneys give out for any reason.

I imagine it is hard for doctors that they don’t really have any safe and effective options to offer their patients in pain.

You have identified the Achilles heel of anti-inflammato­ry pain relievers. In addition to damaging the digestive tract, chronic use of drugs like ibuprofen and naproxen can be hard on the kidneys. There is also a risk of elevated blood pressure and cardiovasc­ular complicati­ons.

Sometimes natural remedies can be easier on the body. We describe a number of herbal approaches in our “eGuide to Alternativ­es for Arthritis.” This online resource can be found under the Health eGuides tab at www.PeoplesPha­rmacy. com.

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