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, Alzheimer’s 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 person’s 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.

Action steps to prevent gum disease

Gum disease is a major cause of tooth loss in adults but it can be prevented or reversed if you take the right steps.

It’s caused by plaque – a sticky film of bacteria that constantly forms on the teeth. These bacteria create toxins that can damage the gums.

However, you can help avoid gum disease by caring properly for your teeth and having regular dental checkups. These are some steps you can take to keep your teeth and gums healthy:

Brush your teeth well twice a day: This removes the film of bacteria from the teeth. Be sure to use a soft-bristled toothbrush that is in good condition. Toothpastes and mouth rinses containing fluoride strengthen the teeth and help prevent decay.

Clean between your teeth every day: You need to remove the bacteria and food particles that a toothbrush can’t reach so you should clean between your teeth with floss or interdental cleaners every day. Your dentist will show you how to do this properly without injuring your gums.

Even if you already have early stage gum disease, it can often be reversed by daily brushing and flossing.

Eat a balanced diet: A good diet based on a variety of foods from the basic food groups, such as grain products; fruits; vegetables; meat, poultry and fish; and dairy products will help your teeth. It’s also a good idea to limit snacks between meals.

Visit your dentist regularly: To prevent gum disease, it’s important to have regular dental checkups and professional cleaning.

Taking the right steps will help you avoid gum disease and can even reverse it if you catch it in the early stages.

How braces can be made to look good

Orthodontic appliances such as braces can be used to help straighten out crooked and crowded teeth.

This is not just about looking better; it also helps improve your dental health.

How they look may determine how you feel about wearing them but, these days, braces can be as inconspicuous as you want.

Brackets � the part of the braces that attaches to each tooth – can sometimes be attached to the back of the tooth, making them less noticeable.

The brackets can be made in a wide range of different materials such as metal, ceramic or plastic.

They can also be designed to look appealing. For example, they may be clear or tooth-colored. There can also be shaped in a variety of ways like hearts and footballs or created in favorite colors.

You could even go for gold-plated braces or glow-in-the-dark retainers!

How your oral health links with your general health

Research has shown strong links between periodontitis (advanced form of gum disease) and other health problems such as cardiovascular disease, stroke and bacterial pneumonia.

And pregnant women with periodontitis may be at increased risk of delivering pre-term and/or having babies with low birth weight.

However, just because two conditions occur at the same time, doesn’t necessarily mean that one condition causes the other. The relationship could work the other way.

For example, there is evidence that diabetics are more likely to develop periodontitis and have more severe periodontitis than non-diabetics.

Alternatively, two conditions that occur together may be caused by something else.

In addition, people who smoke or use alcohol have a higher than average risk of developing periodontitis and other conditions, including oral cancer.

Research is looking at what happens when periodontitis is treated in individuals with these problems.

The aim is to find out whether periodontitis does have an effect on other health problems.

If one caused the other, improvement in periodontal health would also improve other health problems.

While the research is not yet conclusive, the potential link between periodontitis and systemic health problems, means that preventing periodontitis may be an important step in maintaining overall health.

In most cases, good oral health can be maintained by brushing and flossing every day and receiving regular professional dental care.

How dentistry has developed over the last 300 years

When you visit a modern dental surgery, it’s hard to imagine the challenges of dental treatment without all the latest technology.

Yet specialists have been taking care of people’s teeth for thousands of years.

Here are some of the key developments over the last 300 years.

1723: French surgeon Pierre Fauchard – credited as being the father of modern dentistry – publishes the first book to describe a comprehensive system for the practice of dentistry.

1760: John Baker, the earliest medically-trained dentist to practice in America, immigrates from England and sets up practice.

1790: John Greenwood adapts his mother’s foot treadle spinning wheel to rotate a drill.

1790: Josiah Flagg, a prominent American dentist, constructs the first chair made specifically for dental patients.

1832: James Snell invents the first reclining dental chair.

1841: Alabama enacts the first dental practice act, regulating dentistry in the United States.

1844: Horace Wells, a Connecticut dentist, discovers that nitrous oxide can be used as an anesthesia and successfully uses it to conduct several extractions in his private practice.

1880s: The collapsible metal tube revolutionizes toothpaste manufacturing and marketing.

1890: Willoughby Miller notes the microbial basis of dental decay in a book which started a world-wide movement to promote regular toothbrushing and flossing.

1896: New Orleans dentist C. Edmond Kells takes the first dental x-ray of a living person in the U.S.

1938: The nylon toothbrush, the first made with synthetic bristles, appears on the market.

1945: The water fluoridation era begins when the cities of Newburgh, New York, and Grand Rapids, Michigan, add sodium fluoride to their public water systems.

1950s: The first fluoride toothpastes are marketed.

1960: The first commercial electric toothbrush, developed in Switzerland after World War II, is introduced in the United States. A cordless, rechargeable model follows in 1961.

Taking care of removable partial dentures

If you have removable plastic dentures, it’s 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.

It’s 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.

Don’t 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.

Making the most of your smile

Your smile is a major factor in the impression people get when they meet you.

And the good news is that you now don’t have to settle for a smile spoiled by stained, chipped, or misshapen teeth.

Advances in dental treatment mean there is a wide range of choices to help you get the smile that you want. Here are some of the options:
– Tooth whitening (bleaching) can help brighten teeth that have become discolored or stained. It can be done in the dental office or with a system the dentist can give you to use at home
– Bonding improves the appearance of teeth that have become chipped, broken, cracked or stained. This is done by bonding tooth-colored materials to the tooth surface
– Enamel shaping involves modifying teeth to improve their appearance by removing or contouring enamel
– Veneers are thin custom-made shells of tooth-colored materials designed to cover the front side of teeth. They are used to treat spaces between teeth and teeth that are chipped, stained or poorly shaped.
– Braces may be needed if teeth are crooked, crowded or do not meet properly – and not just for kids

Even small changes can have a big impact on your smile and so make a huge difference to how you look and how you feel about yourself.

If you’d like an even better smile, your dentist will be able to give you information about the options available.

How to take care of your teeth with braces

Braces are orthodontic apparatus used to help fix crooked and crowded teeth.

While modern braces can be comfortable and inconspicuous, you may have to take extra steps to care for your teeth when wearing them.

It’s important that you continue good oral hygiene practices while wearing braces.

You need to continue brushing regularly, following the approach suggested by your dentist, as well as flossing daily and making regular visits to the dentist.

People with braces should stick to a balanced diet and limit the number of snacks between meals.

Your dentist may suggest that you avoid certain foods that could interfere with braces or accidentally bend the wires. This can include nuts, popcorn, hard candy, ice and sticky foods such as chewing gum or caramel.

You can still continue to enjoy sports and other activities but a protective mouth guard is often recommended to reduce the risk of injury to the mouth or jaw. Your dentist will suggest an appropriate mouth guard when the braces are in place.

Braces can make a big difference to your smile and your future dental health. Modern technology � and following good practices � means you should be able to wear them with comfort and confidence.

How a bridge can bring back your smile even with missing teeth

If you’re missing one or more teeth, it probably affects your smile and you may also notice a difference in chewing and speaking.

But there are options available to help you restore your smile and limit other problems.

For example, a bridge – sometimes called a fixed partial denture – replaces missing teeth with artificial teeth.

Bridges help maintain the shape of your face, as well as reducing the stress in your bite by replacing missing teeth.

They literally bridge the gap where one or more teeth may have been previously.

The restoration can be made from gold, alloys, porcelain or a combination of these materials and it is bonded onto surrounding teeth for support.

Bridges can be removable � so that you can take them out and clean them – or fixed and so can only be removed by a dentist.

An implant bridge attaches artificial teeth directly to the jaw or under the gum tissue.

Your dentist will recommend which approach is best for you.

Whatever type of bridge you choose, its success depends on its foundation. So it’s very important to keep your remaining teeth healthy and strong.

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.