Oral Hygiene

A new year brings with it new hope, optimism, and motivation to improve; after 2021 we could all use some of that. Many people choose to focus on their health at this time of year, aiming to exercise or partake in a specific diet, but if you are not focusing on your oral health too, you could be missing out on an important part of your wellbeing.

Oral irrigators or water jets work by using pressured water or mouthwash to dislodge biofilm (plaque) from gaps between the teeth, around the gum margin and into periodontal pockets. An oral irrigator can also be used on orthodontic appliances and people who have crowns and bridges.

Day-to-day maintenance of oral hygiene is a basic need for everybody. Overlooking it can lead to health problems, discomfort and lowe­r quality of life. For people with special needs, it is often their carers who hold responsibility for ensuring that their teeth and gums are kept as healthy as possible.

If you’re a carer, you’ll know that this is no easy task. Many people in your position have never received guidance on how to look after the teeth of the person in your care, but we’re here to help with some suggestions.

If the person you care for has a physical disability that prevents them from cleaning their own teeth, but has no aversion to you doing it for them, then it’s really just technique you need to focus on. It may be easiest to stand like a dentist whilst the person sits in a chair with their head tilted back. Always hold the brush at a 45 degree angle to the point at which the teeth meet the gums. Don’t use too much water and make a system to ensure that no

In general the interdental brushing technique involves the following:

1. Place the tip of your interdental brush at the point where you wish to insert it between your teeth and probe it gently to find the best angle to begin to insert without needing to force it. You will find some angles work better than others.
2. Before you insert the brush tip too far first rotate it to a more horizontal angle, this will allow for better cleaning and more control.
3. Slowly and gently push the brush into the interproximal area between your teeth until the other side is reached. If you feel resistance or pain it is best to stop and carefully try again. Use a back and forth brushing motion to clean your teeth and gums, usually once will be enough to dislodge any matter that may have accumulated. Be sure to rinse the brush thoroughly afterwards, and replace the cap if it came with one.

If you find inserting the brush between your teeth is impossible, you may need to

The use of dental floss is appropriate to clean the interdental gums that completely fill the spaces between the teeth. It doesn't cause damage to the gum if introduced from 2 - 3 up to 5mm beyond the top of the papilla.

• Cut approximately 40 or 50 cm of floss and coil most of it around the middle finger of one of your hands. Coil the rest in the opposite hand, this finger can be gathering the dental floss as it is used.
• Hold firmly the tape or dental floss with the thumb and the index, allowing a distance of 2 or 3 cm between the fingers of each hand and with a soft saw-like movement insert it between the teeth against the tooth surface to clean it.
• When the tape or dental floss reaches the edge of the gums, bend it in as a C against one of the teeth and slide it softly into the space between the gum and the tooth until you notice resistance.
• Repeat this procedure with the rest of the teeth without leaving any space to clean.

It is not unusual for parents and carers responsible for the day to day care of autistic children and adults to find it difficult to encourage the person with autism to clean their own teeth and mouth. Equally delivering this care can be even more difficult.

It is essential that mouth care is delivered. The obvious reason for this is to maintain good hygiene and quality of life. It is also considered a form of abuse if oral care is neglected and you are the carer (Department of Health ‘No secrets’ publication).

Trust plays a major role in co-operation and compliancy with mouth care. Give plenty of time and room when care is provided. There is no law to say when mouth care should be delivered, so wait until they are ready or in the right mood for the delivery of care – but don’t break a routine if you know it works for them. Use your knowledge of the individual to assess when or where is a good time for them to be relaxed about mouth care.

Every

While it is possible for bad breath to emanate from the stomach and the lungs it is in the majority of cases attributable to the mouth or oral cavity. In the mouth there are over 700 different types of bacteria, constantly multiplying to numbers in the millions. Plaque or dental biofilm is the sticky colourless substance that is formed when these bacteria combine with food debris trapped in between the teeth and gums. Bacteria feed on and decompose these food particles resulting in the release of a number of odour emitting gases, the cause of the nasty smell. It stands to reason that the more biofilm, the more bacterial activity and the greater the volume of gases produced. Therefore individuals with poor oral hygiene, gum disease or simply a higher genetic predisposition to plaque are more likely to suffer from bad breath. What is ‘morning breath’? While we sleep our saliva glands produce significantly lower levels of saliva then during waking hours. The dry mouth effect

Research shows that there are close to 700 species of bacteria naturally present in the mouth. These together with the teeth, gums and alveolar bone, form an ecosystem. Under normal conditions these bacteria are generally harmless, however should the balance of the ecosystem be upset this will potentially give rise to the accumulation of bacteria in the form of biofilm or dental plaque. Some of the main causes of this imbalance are poor oral hygiene, dietary, drugs and hormonal changes. What is Gum Disease? If biofilm or plaque is not removed it can reach levels that are detrimental to gingival health, resulting in gum disease. The first stage of gum disease is Gingivitis, an inflammatory process confined to the soft gum tissue and because the teeth supporting tissues are not affected the process is reversible. Should this gingival infection go untreated it will lead to degeneration of the periodontal tissue, the tissues that form the tooth support and the underlying bone.

Things have come a long way since we put baking soda on our fingers to clean our teeth and had to wear wooden dentures if they fell out! Thank goodness! Nowadays, we have an enormous assortment of dental health and dental care products to help us get rid of plaque and bacteria that are gentle on our gums. Still, people are visiting the dentists so what is going wrong? There is so much more to know about dental health than simply brushing twice a day to get white, cavity free teeth, so we have compiled a top ten list that covers everything you need to know about oral care.

• Brushing
  It is important to brush first thing in the morning to remove plaque and bacteria that have accumulated over night and to brush last thing at night because saliva (which helps to keep the cavity-causing plaque off teeth) dries up as we sleep. Toothbrushes should come with a small head and soft bristles. Set a timer for 2 minutes, hold the brush