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 areas are missed.

If the person you care for has a behavioural or psychiatric issue, such as advanced dementia, that makes it difficult for you to clean their teeth, then you will need to find a mutually beneficial solution.

Before you start, find some way of explaining what it is you are going to do and make them comfortable. If the sensations of brushing cause problems (common in children with autism) try different flavoured or unflavoured toothpastes, or use a more discreet fingertip brush. Routine may be important, so try to always brush in the same manner and order, and at the same time of day. If clamping occurs, try using a mouth rest, dental shield or a second toothbrush to keep the teeth apart.

Don’t worry too much if the person can’t rinse out all of the toothpaste. Neither should bleeding gums be a huge concern – although it’s a sign of unhealthy gums, this should improve with time as bacteria is swept away. Go to the dentist if it doesn’t clear up.

Help prevent problems by limiting their intake of sugary foods, or at least limit sweet treats to mealtimes. And last but not least, dental health professionals are far more qualified than you to look after the oral health of your patient or family member. Even if you only visit your dentist once a year (or less!), do make sure you take the person in your care to a qualified special care dentist at least every six months so that any problems can be spotted sooner rather than later.