Caring for people who have special needs

People at any age can have a condition that makes it difficult for them to look after their own dental health.

This could affect people who suffer from a wide range of conditons such as stroke, spinal cord injury, multiple sclerosis, mental retardation, Down syndrome, genetic disorders, Alzheimers disease or arthritis.

However, people in all of these categories have the same dental needs as everyone else – they need daily brushing and flossing, regular dental visits and a balanced diet.

There are some steps caregivers can take to make it easier to look after people in those categories.

If the person is uncooperative or uncontrollable, try to explain what you are about to do and schedule the task for a time of day when they are rested.

Move in a calm, slow, reassuring manner to avoid startling them. Give praise and encourage them when they help themselves.

Support the persons head, and take special care to prevent choking or gagging when the head is tilted back.

If the person is unable or unwilling to keep their mouth open, your dentist will explain how you can make and use a mouth prop.

Ask your dentist for advice on how to care for people with special needs and check if they have facilities for caring for these needs in the dental office.

Why a dental abscess should be treated quickly

If you have any kind of swelling in your gum, it almost certainly indicates a serious infection that should be treated urgently.

Dental abscesses result from a bacterial infection in the teeth or gums.

For example, it may come from an untreated cavity. Cavities result when some of the bacteria in our mouths mix with sugars and starches in our diet to produce acid.

This acid attacks the hard enamel coating of our teeth and, as the cavity gets deeper, it eventually infects the nerve and blood supply of the tooth.

In some cases, a dental abscess is caused by an infection of the gum. Bone loss from gum disease can create a pocket between the tooth, gum and bone.

When bacteria and other debris get into this pocket, an abscess can form.

The treatment for an abscess depends on how severe the infection is.

If the abscess has been caused by decay, root canal treatment may be needed or the tooth may even have to be removed.

If the abscess has been caused by the gum, the gum will need deep cleaning or surgical treatment. Again the tooth may need to be removed.

Sometimes, a small incision may be made into the gum to drain the abscess. If this happens, antibiotics and pain medication may be used to relieve discomfort.

If you wait until the gum is severely swollen before seeking treatment, the situation can become very serious.

The abscess at this stage can prevent you breathing properly and can be life-threatenting.

So if you have any signs of swelling in your gum, contact your dentist immediately.

Taking care of removable partial dentures

If you have removable plastic dentures, its important to look after them carefully.

You should brush them each day to remove food deposits and plaque. This also helps prevent them from becoming permanently stained.

It’s best to use a brush that is designed for cleaning dentures as it has bristles arranged to fit the shape of the denture. But a regular, soft-bristled toothbrush is also acceptable.

Avoid using a brush with hard bristles as these can damage the denture.

When you are handling a denture, hold them carefully. Try standing over a folded towel or a sink of water with them in case you accidentally drop them.

Its advisable to use a denture cleanser which has the American Dental Association seal of acceptance. However hand soap or mild dishwashing liquid are also acceptable for cleaning dentures.

Other types of household cleaners and many toothpastes are too abrasive and should not be used for cleaning dentures.

A denture can lose its proper shape if it is not kept moist. So it should be placed in soaking solution or water at night though one with metal attachments could be tarnished if placed in soaking solution.

As you age, your mouth naturally changes, which can affect the fit of the denture so, if they no longer fit properly, they should be adjusted by your dentist.

See your dentist promptly if your denture becomes loose as this can cause sores or infections.

Dont try to adjust or repair your denture yourself as this can damage the appliance beyond repair.

When you wear a partial denture, you need to continue brushing twice a day and cleaning between your teeth daily. This will help prevent tooth decay and gum disease.

Pay special attention to cleaning the teeth that fit under the denture’s metal clasps. Plaque that becomes trapped under the clasps will increase the risk of tooth decay.

Your dentist or dental hygienist can demonstrate how to properly brush and clean between teeth.

Regular dental check-ups and having your teeth professionally cleaned are vital for maintaining a healthy smile.

Understanding your wisdom teeth

Many patients ask whether wisdom teeth are really necessary since so many people have them removed.

The fact is that wisdom teeth are a valuable asset to the mouth when they are healthy and properly positioned.

However, problems can occur that sometimes make it better to have them removed.

For example, when the jaw isn’t large enough, the wisdom teeth can become impacted – misaligned or unable to grow in properly. They may grow sideways, emerge only part way from the gum or remain trapped beneath the gum and bone.

The reasons wisdom teeth may have to be extracted include:
– The teeth have only partially erupted. This leaves an opening for bacteria which cause infection.
– There is a chance the wisdom teeth will damage adjacent teeth.
– A cyst forms which may destroy surrounding structures such as bone or tooth roots.

Ask your dentist about the health and positioning of your wisdom teeth.

Your dentist will tell you if there are any issues and will recommend any steps needed.

Is bottled or tap water better for your teeth?

With many people concerned about the taste and purity of tap water, the sales of bottled water have increased significantly in recent years.

Tap water goes through a process of purification designed to eliminate suspended materials, remove tastes and odors and kill microorganisms.

Fluoride is added to most tap water supplies with the aim of reducing cavities.

Fluoride becomes incorporated into our teeth as they develop and makes them more resistant to decay. It can reverse the progress of early cavities and reduce the need for dental treatment.

Mass water fluoridation has played an important role in reducing tooth decay.

The problem with bottled waters is that they usually don’t contain fluoride.

So there is a risk that drinking bottled water can increase the risk of cavities for some people.

If you drink a lot of bottled water, you can make up for this by using fluoride toothpaste and mouth rinse.

Your dentist may even suggest a fluoride supplement if they notice an increase in cavities.

Common mouth sores: causes and cures

Mouth sores can be very annoying and painful and can have many causes.

The causes can range from infections – bacterial, viral or fungal – to a loose orthodontic wire or a denture that doesn’t fit or a sharp edge from a broken tooth or filling.

But mouth sores may be symptoms of an underlying disease or problem.

So, if you’ve had any mouth sore that lasts a week or longer, its a good idea to get your dentist to check it out.

Here are some of the most common mouth sores:

Canker sores: These are small ulcers with a white or gray base and a red border. They appear inside the mouth and are not contagious though they often return. Problems such as poor immune systems, viruses or fatigue and stress may be involved. They usually heal on their own after a week or two.

Cold sores: Cold sores are annoying and painful. They are also known as fever blisters or Herpes simplex and are groups of fluid-filled blisters. They often erupt around the lips and sometimes under the nose or around the chin. Cold sores caused by herpes virus type 1 are very contagious and the virus stays in the body. Cold sore blisters usually heal in a week by themselves.

Candidiasis: This fungal infection (also called moniliasis or oral thrush) occurs when the yeast Candida albicans reproduce in large numbers. It is common among denture wearers and people who have dry mouth syndrome are very susceptible to it. The focus is on preventing it or controlling the conditions that caused the outbreak.

Any mouth sores that last more than a few days should be checked with your dentist.

What to do if your tooth cracks

While our teeth are normally very strong, they can crack for a number of reasons.

Reasons could include tooth decay, trauma/injury, grinding of the teeth or a stress fracture.

Sometimes, our jaw may be stronger than our teeth and the teeth can fracture when we bite heavily on food.

We can protect our teeth in some circumstances – for example it may be advisable to wear a mouthguard during sports.

Taking proper care of the teeth and regular visits to the dentist will help keep your teeth in good shape.

If a tooth cracks, it may become painful if the nerve is exposed and the area can become tender.

If this happens, rinse your mouth with warm water to clean the area and apply a cold compress to reduce swelling. Then call your dentist immediately.

Treatment will depend on where the tooth has fractured, how close it is to the nerve and the overall condition of the tooth.

A cracked tooth may be repaired with silver alloy, gold, porcelain or plastic. Or it may require a crown or overlay or bonding, which applies porcelain or enamel to the fractured tooth.

If you contact your dentist quickly, they will be able to take the most approriate action to preserve the tooth as much as possible.

Tips for people with difficulty handling a toothbrush

There are many people who find it difficult to look after their dental health properly because they have problems handling a toothbrush.

This can be due to a severe physical disability or simply basic dexterity problems.

There are a few simple steps you can take to make it easier for people who find it difficult to hold on to a toothbrush or dental floss.

Here are some simple ‘home remedies’:

– Use a wide elastic band to attach the brush to the hand

– Enlarge the brush handle with a sponge, rubber ball or bicycle handle grip

– Wind an elastic bandage or adhesive tape around the handle

– Lengthen the handle with a piece of wood or plastic such as a ruler, popsicle stick or tongue depressor

– Tie floss into a loop for easier handling

– Use an electric toothbrush or commercial floss holder

Your dentist will be able to provide specific guidance and further tips for people who need an easier way to handle a toothbrush and floss.

Diabetes and your dental health: How your diet can affect your teeth

When diabetes is not controlled properly, high glucose levels in saliva may create problems that lead to an increased risk of tooth decay.

Your teeth are covered with plaque, a sticky film of bacteria. After you eat food that contains sugars or starches, the bacteria react with these sugars to release acids that attack tooth enamel. This can cause the enamel to break down and may eventually result in cavities.

Brushing twice a day with fluoride toothpaste and cleaning between your teeth with floss or an interdental cleaner helps remove decay-causing plaque.

Plaque that is not removed can eventually harden into calculus, or tartar. When tartar collects above the gumline, it becomes more difficult to clean thoroughly between teeth. This can lead to chronic inflammation and infection in the mouth.

Because diabetes reduces the bodys resistance to infection, the gums are among the tissues likely to be affected.
Periodontal diseases are infections of the gum and bone that hold your teeth in place. Patients with inadequate blood sugar control appear to develop periodontal disease more often and more severely, and they lose more teeth than those who have good control of their diabetes.

Because of the lower resistance and longer healing process, periodontal diseases often appear to be more frequent and more severe among persons with diabetes.

You can help reduce these risks through good maintenance of blood sugar levels, a well-balanced diet, good oral care at home and regular dental checkups.

The secrets of avoiding gum disease as an older adult

Gum disease also known as periodontal disease often progresses slowly, without pain, over a long period of time and thats one reason it is common among older adults.

The longer the disease goes undetected and uncontrolled, the more damage it causes to gums and other supporting tissues.

Although periodontal disease is caused by plaque, other factors can increase the risk or severity of the condition, including:
– Food left between the teeth
– Tobacco use smoking and smokeless tobacco
– Badly aligned teeth
– Ill-fitting bridges or partial dentures
– Poor diet
– Systemic diseases such as anemia

Although periodontal disease is common, it can be controlled and, if caught in its early stages, it can be reversed. However, in advanced stages, it may require surgery.

Look out for the following warning signs and see your dentist if you notice any of them:
– Bleeding gums when you brush
– Red, tender or swollen gums
– Gums that have pulled away from the teeth
– Pus between your teeth and gums when the gums are pressed
– Loose teeth or teeth moving apart
– Any change in your bite
– Any change in the fit of your partial dentures
– Constant bad breath or bad taste

Keeping an eye out for these problems and having regular dental checkups can help you stop gum disease becoming a major and expensive problem.