Discussing research not the same as giving advice

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Hello, dear readers, and welcome back to our monthly letters column. The holiday season is here, and in much of the nation, colder weather has arrived. Calendars are filling with indoor gatherings, many of them with people outside of our immediate circles. With cases of the flu and COVID-19 on the rise, and a dangerous spike in RSV among children, we urge everyone to please take precautions. Stay up to date with appropriate vaccines for yourself and your family, use a mask when indoors in public spaces and be vigilant about hand hygiene. It’s so much easier to prevent a respiratory illness than to ride one out. And now, onward to your letters.

-- A recent column answered a reader’s question about research into a link between blood pressure and the microbiome of the mouth. Specifically, the study looked at bacteria on the tongue that help produce nitric oxide, a molecule that is beneficial to heart and circulatory health. They found that brushing the tongue may affect these important bacteria. This prompted several letters, including one from a dental hygienist. “I understand the importance of nitric oxide to keep blood vessels softened. But it is produced at the very back of the tongue, which is an area usually not brushed due to gagging,” she wrote. “Tongue brushing is essential to remove biofilm and reduce bacteria that can cause decay and periodontal disease. The majority of the tongue needs to be brushed.”

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Elizabeth Ko, MD and Eve Glazier, MD
Thank you for expanding on the nitric oxide discussion and alerting us to a point of confusion. We are grateful to you for the opportunity to clarify. The column discussed the research, and also said that it is preliminary. It does not advise against brushing the tongue. In answering reader questions, we address a wide range of research and topics. But the only medical advice we give in this column is to eat a balanced diet of whole foods, exercise regularly, stay current with vaccinations and preventive care and to take COVID-19 precautions. We will be even more careful going forward to assure that discussions of research findings are not mistaken for medical advice.

-- A reader who is about to schedule a colonoscopy asked if the doctor, who is new to her, will know about her medical history. “I've been told I have a curve in my colon, which can present difficulties in a colonoscopy,” she wrote. “Will the doctor know this due to my previous colonoscopy, or should I inform him?” Good communication between a patient and their doctor is crucial to good medical care. Even though the details of your previous colonoscopy are part of your medical record, personally alerting your doctor to your special circumstances before the procedure will allow him to prepare and proceed appropriately.

Thank you, as always, to everyone who took the time to write. We read all of your letters and answer as many as we can. You’ve been keeping our inboxes extra busy, so we will be back with a bonus letters column next week.

(Send your questions to [email protected], or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)