Sir, I would like to raise the awareness and knowledge of the profession as to the effects of Lyme disease/Borreliosis and associated infections, both at a personal level and also to patients. I have gleaned much personally after suffering, undiagnosed, for the previous 11 years.

Lyme disease is a spirochete infection (Borrelia), classically after a tick bite. In many ways progress of the infection may be compared to three phases of syphilis. Initially, an erythema migrans around the bite, then general flu-like symptoms in the following weeks and finally the third stage: fatigue, sweats, chills, muscle-skeletal pain and weakness, neuropathies and a bucketful of other multisystemic problems including palsies and dental pains as well as some psychological issues. If the infection is diagnosed early and treated, then that may be the end of it, however, some 5-20% of individuals go on to develop the tertiary phase.

From personal experience it is like trying to work as though your latex gloves were now heavy duty marigolds; unable to hold an air-rotor for more than a five minute stretch, and with difficulty even keeping your foot depressed on a floor pedal. Power naps at every down time during the day; an inability to sit on an operating chair for any period without back or neck pain becoming a distraction. The list could go on. Then the irritability, paranoia and depressions kick in. Dentistry becomes impossible and then you get a diagnosis of depression, signed off work and eventually retire.

In general, Bell's palsy is widely reported, but I have been unable to find figures for the occurrence with this condition. Dropping eyelids, unilateral or bilateral can also be features as can sinusitis and middle ear infections. Orally, there can be dry mouth and thirst and widespread tooth sensitivity even if there seems to be perfect gingival health, intense and at times total pulpitis of all teeth, as though hit by two upper cuts.

Although much is non-specific, and far from comprehensive, it should be acknowledged and I hope this might be of help to readers.