DEAR DR. DONOHUE: My great-grandson, age 4, has had speech defects since he started talking. He begins a sentence and then stutters before he can complete it. He will begin school next year. He is very self-conscious about this.

Also, he wakes up during the night screaming. Who is the best doctor for these situations? — J.A.

ANSWER: About 5 percent of children pass through a phase of stuttering. In 75 percent of cases, you can anticipate that the child will get over it, but 25 percent don’t. Your grandson started stuttering early and still has the trouble at age 4. It’s more likely he won’t get over it spontaneously. The family doctor or his pediatrician needs to assess the problem. He’s had speech problems for so long that he most probably would benefit from seeing a speech-language pathologist. The family’s doctor or his pediatrician will recommend one to his parents.

I don’t know much about stuttering. I do know, however, that saying things like “slow down” and “relax” are not helpful. It’s also not helpful to finish the boy’s sentences. Be patient and let him complete his thoughts. And don’t make an issue of his speech. He’s not responsible and has little control over it.

Another smart move the boy’s parents can make is to contact the Stuttering Foundation of America at 800-992-9392 or online at www.sutteringhelp.org. The foundation gives excellent advice and will suggest the best time for obtaining professional help for the boy.

Your great-grandson’s other problem appears to be night terrors. They come on a few hours after going to sleep. The child screams, has a racing heart and looks frightened, but goes back to sleep quickly. He has no recollection of the event the following morning. For most children, it’s a period they pass through without suffering any consequences. The parents should mention this to the doctor when they see him or her for the stuttering problem.

DEAR DR. DONOHUE: Please write about angular cheilitis. I suffer from it. I have gotten numerous prescription salves and over-the-counter preparations, but nothing helps. It keeps me from getting a good night’s sleep. Doctors and dentists have told me that if I get dentures (I have my own teeth), they will fill out my cheeks, and it will go away. — R.T.

ANSWER: Angular cheilitis is an irritation and inflammation of the corners of the lips, the place where the upper and lower lips meet. The area is red, sometimes swollen, and develops painful cracks that eventually are covered with a crust.

Structural changes in the face that come with aging encourage the pooling of saliva in that area. Poorly fitted dentures are also a possible cause. And some people are in the habit of constantly licking their lips, which deposits saliva in the corners. The yeast candida or the bacterium staph might take up residence there and add to the problem.

First off, get rid of possible infecting agents by using a dab of miconazole cream, twice a day, for two weeks. If you don’t notice a change for the better, do two weeks of Bactroban ointment for staph eradication. Then go on a drying campaign with ChapStick, and continue using it indefinitely.

DEAR DR. DONOHUE: I was treated with radiation for throat cancer. I have had little taste and saliva since. I need condiments or sweeteners in order to enjoy food. A visit to the dentist showed four cavities, probably due to my lack of saliva and the sugar I use. Would honey be a better sweetener? I would think so. Two doctors and the dentist don’t agree. — P.K.

ANSWER: Make that three doctors and a dentist who don’t agree. Think of honey as sugar — that’s what it is. Have you tried artificial sweeteners? They don’t damage the teeth.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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