Dental Health
There are a number of reasons why children and adults with disabilities are at greater risk of dental disease. These can include:
Oral and Dental Conditions
Some genetic disorders can cause defects in tooth structure that make decay more likely while other conditions may mean teeth are out of line.
Physical and Cognitive Limitations
People who cannot chew or move their tongue properly do not benefit from the natural cleaning action of movement of the tongue, cheek and lips. People with poor motor control or coordination may not be able to clean their own teeth or use the usual brushing and flossing methods necessary to prevent dental decay and gum disease.
Special Diets
Some people who have difficulty chewing or swallowing may eat only soft or pureed foods, which tend to stick to their teeth and may increase the chance of tooth decay.
Medications
Some medications contain sugar to disguise the taste but this can cause tooth decay. Other medications can cause erosion or swollen gums and some can reduce saliva flow. Reduced saliva may mean less protection from decay. Antibiotics can cause discolouration of newly forming teeth and should always be prescribed with caution in young children and women who are pregnant.
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The keys to good oral and dental health are a good diet and effective oral hygiene. Any food or drink containing sugars should be restricted to meal times, unless, because of the impairment, such foods are necessary as part of a dietician-supervised diet. Good oral hygiene means either brushing teeth, or having teeth brushed for them at least twice a day, and preferably after every meal. If the disability makes brushing difficult, a dentist may advise the use of a special brush and/or technique.
Regular dental check-ups are very important. If possible, register with a dentist who has experience of treating people with a disability. There are also specialists in dental hospitals. People with medical cards are entitled to free dental services in Ireland. Services are provided by dentists employed by Health Service Executive (HSE) Areas in your area and by private dentists who have contracts with HSE Areas to provide certain services. Visit Citizens Information for more information on entitlement to Dental Services in Ireland.
Specialist dental appliances may be recommended to help correct alignment problems or to protect from damage. Professionals such as occupational therapists and speech and language therapists, also play an important role in advising on equipment, positioning and techniques that will assist with good diet and oral hygiene. If the person with a disability has complex health concerns or requires sedation or general anaesthesia in order to receive dental treatment, it may be necessary for the dentist to liaise with a medical doctor.
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- Eat sensibly. A diet rich in fruit and vegetables helps to stimulate salivary flow which helps to protect tooth surfaces. Avoid starchy and sugary snacks and drinks which speed up the process of decay and/or lead to dental erosion.
- Take care of your teeth and gums. Effective brushing, and flossing if possible, reduces plaque and can help prevent gum inflammation and disease.
- Avoid smoking. Smokers have a much higher risk of developing gum disease compared to non-smokers. They are also at higher risk of developing oral and throat cancers.
- Limit alcohol intake. High alcohol intake also increases the risk of oral and throat cancers.
- Diabetics are at higher risk of dental problems if the disease is not managed properly. Uncontrolled diabetes impairs white blood cells, which are the body's main defence against bacterial infections that can occur in the mouth.
- Special handgrips and straps can be added to ordinary toothbrushes to make them easier to hold for people with poor grip or who have difficulty controlling hand/arm movements. Special toothbrushes may be helpful too. Ask your hygienist about these.
- Electric tooth brushes can be useful and may be seen as novelty or fun to use by some people who do not like brushing their teeth.
- If you are taking medication that results in dry mouth, discuss this side-effect with your doctor who may be able to prescribe an alternative medication or suggest a saliva substitute.
- Change your toothbrush at least every three months or earlier if the toothbrush looks worn.
- If you are not sure, ask your dentist or dental hygienist to show you the best way to brush and floss your teeth.
- Visit the dentist regularly. Problems detected early can be treated early.
- Be sure to remove dentures at night and clean them before putting them back in the next morning.
