Q: I had a hip replacement last year and was told that I need to take antibiotics before I go to the dentist. Really!? -- Katie K., Brookings, S.D.
A: It's not only a good idea, it's essential. Reputable dentists won't work on you if they know you've had an implant and refuse the antibiotic. During dental procedures, bacteria living in your mouth -- and there are tens of thousands of them -- can spread into your blood and lodge on the surface of artificial things, like hip, knee or heart-valve replacements. Some of these newer replacement parts have embedded antibiotics, but you still need antibiotics for a dental procedure.
The immune system can't "see" bacteria resting on inorganic (ceramic, metal or plastic) implants, so no white blood cells come to attack and kill them off. They thrive, and you can get a whopper of an infection. Also, over time, a bacterial film can build up in and around the replacement joint, and that can begin to loosen the joint and cause other problems.
Get a prescription for the antibiotics from your orthopedic surgeon or dentist. You'll be instructed to take four or five pills all at once, an hour before your teeth-cleaning or procedure. They decrease the likelihood of bacteria surviving in your bloodstream, but they can give your guts a run for their money (i.e., they can give you the runs). Your best bet is to take a daily dose of probiotics a couple of days before, the day of and for at least a week after you go to the dentist. Lactobacillus and Bifidobacterium are strains found in yogurt, added to soy products and in supplements. We recommend Digestive Advantage or Sustenex (they have armorlike shells that hold up through stomach acid) and Culturelle, a probiotic that actually gets turned on by stomach acid. Now smile -- and get your teeth cleaned.
Q: I've heard dogs can smell when people are sick. Do they sense a change in a person or do they actually smell that something isn't quite right? -- Sarah M., Portland, Ore.
A: A bit of both. Dogs have a remarkable sense of smell -- bloodhounds have almost 50 times as many scent receptors as humans; that translates to a sense of smell that's 10,000 to 100,000 times better than what we have.
Researchers in Germany followed a program developed at Dr. Mike's Cleveland Clinic that trained dogs to detect the smell of a waste product of lung cancer. The German dogs can smell your breath and ID lung cancer correctly 93 percent of the time. A Japanese pooch sniffed the breath and stool samples of more than 300 people and correctly IDed which people had bowel cancer 98 percent of the time. Other studies demonstrate dogs can detect early stage breast cancer, melanomas and bladder cancer with an accuracy rate of 88 percent to 97 percent.
How is this possible? Malignant tumors exude tiny amounts of volatile organic compounds that aren't in healthy tissue. Dogs can sniff out each one in concentrations as dilute as parts per trillion. The dogs' ability to smell VOCs may lead to a new test to detect cancer. If it gets inexpensive enough, maybe we'll all have a breath analysis once a year to spot early, otherwise undetectable, disease.
Cancer isn't the only disease that stinks. Medical dogs can smell a change in blood sugar levels and the presence of ketones (toxic acids in the bloodstream that signal low insulin or high blood sugar), and then alert their owners or others to a potential diabetic seizure.
So, Sarah, pooches do perceive behaviors, and their smell is nary off by a whisker. These canines can make everyone's RealAge younger, and we're for that!
(Mehmet Oz, M.D. is host of "The Dr. Oz Show," and Mike Roizen, M.D. is Chief Medical Officer at the Cleveland Clinic Wellness Institute. Submit your health questions at www.doctoroz.com.)