My two year old is still bottle fed but has white spots on his teeth and bleeding gums. He often cries when feeding. Should he see a dentist at this early age?
This case describes the typical presentation and outcome of ‘nursing bottle decay’ or ‘bottle caries’, which is seen in young children who are not yet weaned from the bottle.
Bottle caries is caused by frequent feeding of sweetened liquids from a bottle, especially before the child goes to sleep. Sugar in the liquid mixes with bacteria in the dental plaque to form acids that attack tooth enamel. Each time a sweet liquid is taken, acids attack the teeth for at least 20 minutes. When children are awake, the saliva is able to remove some of the liquid. However, during sleep, the saliva flow decreases and the sweet liquids collect around the teeth for prolonged periods, bathing the teeth in acids.
The earliest appearance of decay is the enamel turning a chalky white colour, usually around the gum line. Then as more calcium is lost from the tooth, a hole finally appears. In severe cases of bottle caries, the cavities can ringbark the teeth and cause them to break off. At the early stages, the cavities do not cause pain, but as they enlarge, increasing discomfort may be experienced, and dental abscesses may result.
Bottle caries may be treated by fillings or extractions, but because most children are not cooperative at such a young age, they usually need to be sedated. Very often, general anaesthetics have to be given.
The best form of treatment for nursing bottle decay is prevention. Children should not be allowed to sleep with a bottle of sweet liquid. If a child needs a bottle for comfort before falling asleep, fill the bottle with plain water, milk or formula, and remove the bottle as soon as the child is asleep. Dummies should never be dipped in honey.

For two years I have had a strong metallic taste in my mouth that makes me feel sick. Have you any ideas as to a cause?
By far the most common cause of abnormal taste sensations is the side effects of any one of a number of medications. Differenr drugs used for arthritis, bacterial and fungal infections, psychiatric disturbances, high blood pressure and heart failure may all cause strange tastes.
Other causes include thyroid gland disease, strokes that affect the taste-sensing area of the brain, radiation treatments to the face, viral infections and degeneration of the brain with age.
Differentiating between these various causes may be quite difficult, but if you are on medication of any sort (including vitamins, minerals and over-the-counter medicines) it would be worthwhile discussing with your doctor if these can be safely ceased to see if they are responsible.

I am 68, and over the past 3 years have gradually lost my sense of smell, but can still taste sweet and sour. A specialist has told me that nothing can be done. Is that true?
The senses of smell and taste are totally independent of each other, and so it is certainly possible to lose one sense and not the other.
The sense of smell comes from tiny nerve endings that project through the thin bone at the top of the nose. These nerve endings respond to different aromas in different ways, the subtlety of which is poorly understood by physiologists. The appropriate nerve impulses are then carried to a part of the brain that interprets these as the smells we know.
Man has a relatively small part of the brain devoted to smell (it is much larger in dogs), and if the blood supply to this part of the brain, or the olfactory (smell) nerve is reduced, the sense of smell may be lost. This can occur in old age from a mild stroke or hardening of the arteries, and is relatively common in smokers. There is no treatment available. Taste results from four different types of receptors on the tongue, which can detect sweet, salty, bitter and sour (and combinations of these). Taste is a far coarser sensation, and it is only the combination of smell and taste that makes us appreciate different foods.
I regret, that with taste alone, your garlic prawns and fresh strawberries are not going to be the pleasure of years past.