Dear Dr. Gott: I am an 83-year-old female and have most of my teeth, several of which were filled a few years ago. For several months, little broken bits of my teeth have been appearing in my mouth. Why is this? I haven't seen a dentist recently but wonder whether there is a danger if these pieces are swallowed.

I've been on medication for about eight months following a mastectomy. Is there any connection there? I'm also on blood-pressure and arthritis medications.

Reply: Congratulations on having your own teeth at 83. As we age, our bodies begin to deteriorate, and this includes our teeth. It is my guess that small bits of your teeth are breaking off as you chew food. Perhaps you grind your teeth while sleeping. Or maybe your fillings are wearing away, and what you are seeing is material your dentist repaired cavities with.

Unless the pieces are extremely large, I don't believe there is any danger should pieces break off and get swallowed. I don't believe your hypertension or arthritis medications have contributed to the problem; however, without knowing which drugs you were prescribed, I cannot rule them out with certainty. The same applies to any medication you are taking following your mastectomy. As a result, it is difficult for me to determine a possible connection. To be safe, make an appointment with your dentist and let him or her have a look at your teeth. Bring a list of your medications for his review to determine if one or more may be the culprit. If he or she cannot answer questions regarding a possible connection, make an appointment with your primary-care physician, who should be able to fill in the blanks.

Dear Dr. Gott: I'm 77 years old and have a protruding bladder that is bothersome. I also have a bad odour that I suppose stems from the dropped bladder.

I would like to know if it would be feasible for someone my age to go through an operation and just how bad the surgery might be.

Thank you in advance for your answer.

Reply: A cystocele (dropped bladder) occurs when the wall that separates a woman's bladder and vagina weakens, allowing the bladder to drop into the vagina. This results in urinary incontinence and an inability to empty the bladder completely.

There are a number of reasons for a cystocele to occur, including straining from repeated heavy lifting, childbirth, hormone deficiency or chronic constipation.

A cystocele is graded in terms of severity from I to IV. Women with mild prolapse (I-II) can experience relief with pelvic floor exercises and physical therapy with behavioural modification. Those with moderate prolapse (II-III) and those who are not surgical candidates may benefit by using a pessary. Surgery is the preferred treatment for severe prolapse (IV). Endoscopic procedures are now available in a number of cases and are less invasive with shorter recovery times. You should return to your gynaecologist for his or her input. Ask if surgery is an appropriate option or if something else might be more appropriate at this time. Perhaps a pessary can hold your pelvic organs in position.

This removable insert will not cure the prolapse, but might make you more comfortable. To answer your question, your age should not be a problem if you are otherwise healthy enough to undergo surgical repair. I do not have that information and cannot advise you on the matter. Try the pessary first.

To provide related information, I am sending you a copy of my Health Report 'Vaginal Infections and Disorders'.Other readers who would like a copy should send a self-addressed stamped number 10 envelope and a cheque or money order for $2 to Newsletter, PO Box 167, Wickliffe, Ohio 44092. Be sure to mention the title.

Dr. Peter Gott is a retired physician and the author of 'Dr. Gott's No Flour, No Sugar Diet' and 'Dr. Gott's No Flour, No Sugar Cookbook'. Contact him c/o United Media, 200 Madison Avenue, fourth floor, New York, New York 10016.