Advice: Helping with Oral Hygiene
Do you help someone maintain their oral health? Good dental health is vital for everyone because a healthy mouth is important for speaking, eating, and overall wellbeing.
Many serious conditions can first be detected in the mouth. People with dementia or other conditions that impair judgement, or who can’t easily move their hands, are especially likely to have dental problems.
Here is advice to help your family member maintain their oral health, or you may have to do these important care tasks for them.
Care is needed for teeth, gums, and prostheses (dentures, plates, and so on). Your family dentist is a key source of advice and useful products to maintain oral health. Ask the dentist how often visits should be planned for professional cleaning, and for an overall check.
If your family member has limited mobility, try a rubber grip on the handle of the toothbrush; these can be purchased at mobility product shops, chemists, and some Disability Information Centres.
Electric or battery-operated toothbrushes have thicker handles so may be easier to grasp and use; they also do a better job of removing food particles and plaque build-up than an ordinary toothbrush. These are now reasonably priced, and available from your supermarket, chemist, or dentist. You can buy replacement heads for some models at the same outlets.
Use a soft or medium bristle toothbrush and fluoride toothpaste. Stand behind your family member to brush (floss from the front).
Brush teeth with a gentle circular motion on outside and inside surfaces of teeth and biting surfaces (electric and battery-operated toothbrushes will do this automatically … they just have to be propelled around the mouth).
Be careful about brushing your family member’s tongue, which can be irritating and cause gagging. On the other hand, gentle brushing of the tongue can remove debris and bacteria. Some brushes have a tongue cleansing head.
Ask your dentist or hygienist for advice. Toothbrushes should not be shared, and should be replaced every three months.
Flossing is important to dislodge trapped food particles that can cause tooth decay and odours. This can be a difficult task for people who are unwell or have reduced mobility.
You can buy flossing brushes and other aids from your dentist, chemist or supermarket. Pleasant tasting and fluoride treated flosses are also available.
Be gentle with older teeth and gums; they can be easily damaged or irritated.
Wear disposable gloves if you help your family member with brushing and flossing. This will protect you both from hygiene risks. Disposable gloves are available at the chemist or supermarket; they are inexpensive and come in fun colours for home use.
Soak dentures overnight in a denture cleaning solution.
Each morning gently brush your family member’s gums and the roof of their mouth with toothpaste to remove plaque and stimulate blood flow. Dentures should be cleaned every day to remove plaque, food, and prevent staining.
Clean dentures over a basin of cold water to avoid damage if they are dropped. Clean all surfaces with toothpaste or a denture cleaner and a small toothbrush (soaking only loosens debris; brushing is important too). Once a day is enough.
Remove dentures after meals to rinse them and your family member’s mouth. If using dental paste, clean old paste from gums and dentures before re-inserting dentures.
Don’t try to fixed broken, chipped, or cracked dentures at home. Take them to the dentist for a professional repair. If your family member’s dentures become loose or don’t fit as well as they used to, see the dentist straightaway. Poorly fitting dentures can cause painful sores.
If you notice a build-up of stain or scale on dentures, have them cleaned by the dentist or hygienist.
Your family member’s mouth will need a rest from wearing dentures. Soak them overnight or at other times that are convenient.
Always put dentures in cold water when your family member is not wearing them, to prevent warping.
Oral Care Aids
Try antiseptic mouthwashes and oral rinses. These are available from the supermarket or your chemist.
Dental gum should not be used by those with dementia or swallowing difficulties.
Visiting the Dentist
Those who rely on others to maintain their oral health should visit a dentist and/or hygienist regularly (every three or four months).
When booking an appointment, say your family member may need extra time for treatment. Ask for an appointment at a quiet time in the office. Many dental offices have wide doors, ramps, and accessible toilets. When choosing a dentist, ask if these are available; they are signs of a practice that is thoughtful about the needs of older people or those with mobility needs.
If your family member has dementia or some neurological impairments, visiting the dentist can be unsettling. Communicate clearly about the purpose of the appointment and schedule for times of the day when your family member is most alert, or when the office is less busy.
If your family member becomes agitated during oral health visits, talk to the dentist or hygienist about ways to minimise pain and agitation.
Develop strategies to ensure your family member receives regular oral health care.
See the dentist or GP if you notice any of these signs
Change in how teeth fit together
Red, swollen, or tender gums
Pus at the gum line
Change in fit of dentures or plates
Very bad breath
Change in ability to swallow or speak
Facial pain or swelling
Loss of taste
Loose or chipped teeth
An ulcer that does not heal
White film in the mouth could indicate infection (thrush)
We thank the New Zealand Dental Association for its assistance with this article. You’ll find other helpful oral health tips and ideas at the Healthy Smiles website.
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