As we know, excellent oral hygiene is crucial for maintaining oral health and ensuring a good quality of life. However, for some patients, keeping the teeth and gingiva clean is physically challenging. Certain medical conditions can make personal hygiene difficult. For example, patients with impaired motor skills or memory can find this particularly difficult.
Conditions which pose challenges
A number of conditions impact a patient’s ability to perform effective oral hygiene. This might mean that patients are unable to move normally or have problems with memory. Some of the most common of these conditions include multiple sclerosis (MS), cerebral palsy, epilepsy, rheumatoid arthritis, Parkinson’s disease, Alzheimer’s disease, or having had a stroke.
Reduced mobility can make it difficult for some patients to open their mouth or to hold and move a toothbrush properly. This can mean that it’s difficult to remove plaque from all tooth surfaces leading to an increased risk of gingival irritation and inflammation, and oral diseases such as caries, gingivitis, and periodontitis. These conditions can be painful, and can lead to infections and tooth loss in the long-term.
When the memory is affected, this might mean that patients forget to brush their teeth or make and attend dental appointments. It can be helpful to discuss strategies to help manage this with a patient’s family or carers, as this will help them to maintain a good quality of life, and help to keep their mouth healthy. Additionally, some medications or conditions can cause dry mouth – making the mouth feel sore. Because of this, some patients find toothbrushing painful, and the lack of saliva can make them more prone to caries. It’s important to help patients manage this to maintain a healthy mouth.
Helpful adjustments to make a difference
To help maintain a healthy mouth, there are a number of adjustments both to lifestyle and oral hygiene that could be made. It’s important for patients (and/or their family or carers) to understand how best to take care of the mouth, and the effects that certain factors can have on oral health.
Firstly, brushing the teeth properly – either independently or with assistance – is important for preventing the development of oral diseases. This means brushing twice a day using toothpaste that contains sufficient fluoride (1350-1500ppm). Interdental cleaning once per day is important for removing plaque in areas regular brushing cannot reach – demonstrating this effectively is crucial for solidifying patient understanding.
Making lifestyle adjustments can also be key for prevention. This might mean increasing the amount of fruit and vegetables patients eat, cutting down on sugary food and drink, and opting for sugar-free versions where appropriate. Limiting the amount of alcohol patients consume can also be helpful for protecting oral health, as can quitting smoking—both of these can increase the risk of mouth cancer.
Regular dental appointments are essential. Where dental professionals are able to monitor patients’ oral health status regularly, they will be able to more easily intervene and prevent the development of oral diseases. Clinicians should also recommend solutions for dry mouth, where applicable, to help make brushing easier, and more comfortable.
Targeted solutions for periodontal health
The implications of poor oral hygiene on soft tissue health can be substantial. If the gingiva becomes consistently inflamed, red, and sore, the patient may develop periodontitis. The disease is characterised by bleeding, swelling, pain, and bad breath and, in severe cases, it can cause the gingiva to pull away from the tooth and bone. Eventually, if left untreated, tooth loss is a possibility. Periodontal disease is estimated to affect around 19 per cent of adults globally.
In some cases, particularly for patients who find toothbrushing difficult, mouthwash can be a helpful tool. This should be used at a different time than toothbrushing and, with the right ingredients, may help patients keep plaque levels under control. Perio plus Balance Mouthwash from Curaprox reduces the risk of tooth decay and is ideal for long-term use. This makes it a great solution for patients with impaired motor skills, with a chlorhexidine concentration of 0.05 per cent giving patients the benefits of its antibacterial properties, and its unique formula offering long-term protection against harmful bacteria.
If patients struggle to carry out oral hygiene effectively, due to a health condition or a motor issue, it is important to work with them to help find solutions which work for their unique situation. In particular, establishing a routine which is simple to follow and uses tools which are accessible for them will offer the best results. Regular check-ups will help you to monitor their progress, and make adjustments to their routine and offer treatments where needed.