Helping

adults with

special needs

to have a

healthymouth . . .

Introduction

Dental problems can often cause a great deal of pain and treatment can be very stressful.

Therefore, it is very important to keep the teeth and gums healthy to avoid the stress of dental treatment.

Fortunately, the two most common problems, dental decay and gum disease are preventable.

This booklet gives individuals and carers some simple, practical advice on how to keep the mouth looking and feeling great.

The important behaviours required to keep the mouth healthy are using a toothbrush to clean the teeth and gums twice a day with a fluoride toothpaste, and only having sugar at mealtimes.

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If you have any concerns about your mouth – dental professionals have the knowledgeand skills to give you specific personal advice

Keeping the teeth clean

• Make sure teeth are cleaned twice a day with fluoride toothpaste.

• Use a toothbrush with a mediumsoft small head.

• Spit, do not rinse after brushing.

• Some adults find it easier to usean electric toothbrush to cleantheir teeth.

• A member of the Dental Teamcan give you personal advice

about tooth brushing and the appropriate toothpaste to use.

• • 

• For hygiene reasons wear gloveswhen brushing someone else'steeth.

• Try brushing different parts of the mouth at different times.

• Use distraction, such as music,electronic games or TV.

• Brush the teeth in the shower orbath.

• Get the individual to hold ontoa vibrating object such as anelectric toothbrush. It may takethe focus away from the mouth.

How to brush

Outside TeethUsing small circles brush from one side of the mouth to the other

cleaning all the teeth

Inside TeethBrush every tooth on the inside making sure you brush to the gums

Chewing SurfacesGently scrub the surfaces of all the top and bottom teeth, reaching back to the

last tooth

There are several ways to brush but the circle technique is simple and makes sure all the teeth and gums are brushed properly.

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Some people just will not brush!

It is important to persevere, as poor oral health hygiene will lead to decay and gum disease which cause pain.

Patients in pain may then be less likely to cooperate with

oral health care both at home and in the dental clinic.

• A superbrush or a three sidedtoothbrush may help cleanseveral tooth surfaces at once.

• Use two toothbrushes one tobrush while the other distracts.

• A bicycle handle grip or foamtubing placed on the toothbrushhandle will make the brush easier to hold and more stable.

• Two toothbrushes taped back toback help keep the mouth open.

• Massage around the mouth andcheeks to improve muscle toneand saliva flow.

• Use a foam mouth prop to keepmouth open while brushing.

• In some cases applying pressuremidway between the chin andlower lip can reduce the gagreflex.

• Massaging the lips and cheekbefore tooth brushing can helpyou get the brush in the mouth.

• Some carers have found thatthe use of a clean cloth orhandkerchief wrapped aroundthe forefinger to pull back thelips is helpful.

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A strong tongue or tight lips

When brushing is difficult

Be consistent in your approach & encourage

good cooperation

Gagging, Retching or Clamping

An individual can lie back in a chair if they find it difficult to sit upright when having the teeth brushed.

Carers often find i t e asier t o a ssist with brushing if they stand behind the patient, although it may be difficult to see all areas of the mouth.

The lips and cheeks should be gently pulled back, to allow you, to see the teeth.

It is important to brush the area where the teeth and gums meet.

Using a vibrating toy or massager can help people unclench their teeth or help distract the patient while the teeth are brushed.

Many people with special needs require help with tooth brushing

It is not uncommon for gums to bleed slightly

on brushing. Please arrange a dental

visit if bleeding is a persistent problem.

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• Cleaning teeth for patientswho are non-orally fed orhave difficulty swallowing(dysphagia) is very important.

• Leaving plaque and bacteriaon the teeth can lead to chestinfections.

• Brushing the teeth will also makethe mouth feel more comfortableand reduce bad breath.

• To help make brushing easier,tilt the head forward whilstbrushing.

• An aspirating toothbrush whichis attached to suction may beneeded in some cases, these aresometimes used in hospitals.

• Use a low foaming toothpaste,such as Biotene Dry Mouth,Sensodyne or Neutrfluor.

• Use a smaller brush or electrictoothbrush.

• Start brushing from the front,gently moving the brush to theback teeth.

Some patients may suffer from a dry mouth which can be a side effect of some medicines. This makes the teeth more at risk of tooth decay.

• Carers have found ToothMousse Plus and fluoride rinsesuseful in preventing decay askyour dental profession for moreinformation.

• There are some products thatcan also help make the mouthfeel more comfortable and helpreduce decay. Please speak toyour dental professional foradvice.

• Some medical conditions canaffect your oral health so it isimportant you have regulardental assessments.

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Difficulty Swallowing

Medical conditions &Medications

Follow these tips to reduce the amount of sugar taken

between mealsDo not eat sugary snacks between meals. Foods containing sugar e.g. fruit yogurts, muesli bars, biscuits, cakes, chips, dried fruit and fruit drinks should be taken at meal times only.

• Avoid having sugary foods ordrinks last thing at night.

• Have healthy snacks betweenmeals including fresh fruit,vegetable sticks, cheese, nutsand plain yoghurt.

• Try to have meals and plannedsnacks at set times during theday to prevent ‘grazing’ as thisleads to tooth decay.

• Drink tapwaterbetweenmeals.

• Avoid soft drinks, energy & sports drinks, cordial or juice as they arehigh in sugar and are very acidic.

• Avoid tea & coffee with sugaradded as this can lead to toothdecay.

• Ask your Doctor to prescribesugar free medications.

• Give dietary supplements atmealtimes if possible.

Diet

Tooth brushing & toothpaste

Diet

Other information

Please call

if you have any problems or questions

Individual Home Care Dental Plan

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DisclaimerProducts mentioned in this booklet are suggestions only and are not endorsed by NSW Health.

Contact telephone numbers for Public Dental Clinics in NSW

Sydney

South Western Sydney(02) 9293 3333

South Eastern Sydney 1300 134 226

Central Coast 1300 789 404

Murrumbidgee

Southern NSW1800 450 046

Western Sydney (02) 8890 6766

Nepean Blue Mountains(02) 4734 2387

or 1300 769 221

This resource has been developed byNorthern Sydney Local Health District,Oral Health Services

Graphic Design by Mara Cvejic Westmead Centre for Oral Health

SHPN: (COHS)170326Consents and licences have been obtained for all photographs and artwork used in this booklet.

Northern NSW

Mid North Coast

Hunter New England1300 651 625

Far West

Western NSW

Public Dental Health

Call CentrePhone Number

Illawarra Shoalhaven 1300 369 651

Northern Sydney 1300 732 503

(02) 6809 8621

or 1300 552 626