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 conditions 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.

How cancer treatment affects oral health

When someone is undergoing cancer treatment, it’s important that they involve their dentist in their program of care.

They should schedule a dental exam and cleaning before the treatment actually begins and then repeat it periodically during the course of treatment.

It’s important that they tell the dentist that they are being treated for cancer and that they also discuss any dental procedures, such as extractions or insertion of dental implants, with the oncologist before starting the cancer treatment.

It’s therefore a good idea to ensure that the dentist and oncologist have each other’s details to enable them to discuss any issues to help the patient.

And the dentist and physician should be informed about any issues such as bleeding of the gums, pain, or unusual feeling in the teeth or gums, or any dental infections.

Maintaining excellent oral hygiene during cancer treatment is vital to reduce the risk of infection and to help aid the treatment process.

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.

Common questions about dental insurance

Understanding what’s covered by your dental insurance is an important part of making sure you get the best oral care possible.

Here are some common questions that arise when people want to understand their cover better.

– If treatment my dentist recommends is not covered by my insurance, does that mean it’s not necessary?

Some plans make exclusions such as sealants, pre-existing conditions, adult orthodontics, and specialist referrals. This depends on your dental plan and you should not let the level of cover determine whether you need treatment.

– My dental benefit will only pay for a large filling but my dentist recommends I get a crown. Which should I choose?

Some plans will only cover the least expensive solution but it may not be the best option for your needs. You should decide based on your health needs and not on your insurance cover.

– My dental plan says it will pay 100 percent for checkups and cleanings but the insurance company says I owe for part of the dentist’s charge. How can this be?

Some plans provide cover based on a “customary fee” for each procedure. So, if your dentist’s fee is higher, your benefit will be based on a percentage of the customary fee instead of your dentist’s fee. Although these limits are called “customary,” they may not accurately reflect the fees that dentists charge in your area.

– Will my plan cover the care my family will need?
If your employer offers more than one plan, check the exclusions and limitations of the coverage as well as looking at the general benefits. It’s a good idea to discuss your family’s likely needs with your dentist before choosing a plan.

The plan document should specify who is eligible for coverage under the plan.

Plans offered by the same provider or employer can vary according to the contracts involved so your dentist will not be able to answer specific questions about your benefit or predict what the coverage for a particular procedure will be.

If you have specific questions about coverage, talk to your plan provider.

Dry mouth is a common problem that can harm your teeth

If your saliva flow is reduced, this can cause dry mouth which often leads to increased tooth and gum problems.

Dry mouth – known as xerostomia – is a common problem especially among older adults. It’s caused by certain medical disorders and is often a side effect of medications such as antihistamines, decongestants, pain killers and diuretics.

The common problems associated with dry mouth include:

– Constant sore throat
– Burning sensation
– Problems speaking
– Difficulty swallowing
– Hoarseness or dry nasal passages

When there is not enough saliva to lubricate your mouth, wash away food and neutralize the acids produced by plaque, there is a risk of extensive tooth decay.

If you are at risk from this condition, your dentist can recommend various methods to restore moisture.

For example, sugar-free candy or gum stimulates saliva flow, and moisture can be replaced by using artificial saliva and oral rinses.

As dry mouth is a potential side effect of many prescribed and over-the-counter medications it is a very common problem.

These medications can include antihistamines, decongestants, painkillers, high blood pressure medications, muscle relaxants, drugs for urinary incontinence, Parkinson’s disease medications, antidepressants and many others.

Fortunately there are many simple solutions available to reduce the risk to your oral health caused by dry mouth so talk to your dentist if you are on any kind of medication or you feel you may be at risk from this issue.

Different types of dentist and how they help your oral care

While many people see dentists as the single group of people who look after the health of your teeth and mouth, there are various specialist categories that help you in different ways.

The categorization of a dentist will depend on their education, training and experience.

Here are some of the main specialist areas of dentistry:

Endodontics: Concerned with the dental pulp – the part in the center of a tooth made up of living soft tissue and cells and root canal therapy

Oral and Maxillofacial Pathology: This deals with the identification, and management of diseases affecting the oral and maxillofacial regions

Oral and Maxillofacial Radiology: Deals with the production and interpretation of images and data produced by radiant energy that are used for the diagnosis and management of diseases, disorders and conditions of the oral and maxillofacial region

Oral and Maxillofacial Surgery: Diagnosis and surgical treatment of diseases, injuries and defects of the tissues including extractions, facial surgery and implants

Orthodontics and Dentofacial Orthopaedics: Mainly deals with diagnosis, prevention and treatment of misaligned teeth and modification of midface and mandibular growth

Pediatric Dentistry: Provides preventive and therapeutic oral health care for infants and children through adolescence.

Periodontics: Prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth and the maintenance of the health, function and esthetics of these structures and tissues. Most periodontist place implants

Prosthodontics: Diagnosis, treatment planning, rehabilitation and maintenance associated with missing or deficient teeth and/or oral and maxillofacial tissues. Includes dentures, bridges and the restoration of implants.

Plus, of course, general dentists provide everyday care and many specialist services to maintain your oral health.

How smoking affects your teeth

While the general effects of smoking on your health are well-known, it can also have significant effects on your oral health.

Here are some of the ways smoking can harm your oral health and hygiene:

– Oral Cancer
– Periodontal (gum) disease
– Delayed healing after a tooth extraction or other oral surgery
– Bad breath
– Stained teeth and tongue
– Diminished sense of taste and smell

Research suggests that smoking may be responsible for almost 75% of adult gum disease.

Tobacco products damage your gum tissue by affecting the attachment of bone and soft tissue to your teeth. One effect is receding gums which expose the tooth roots and increase your risk of tooth decay or to sensitivity to hot and cold in these unprotected areas.

Cigar smoking is equally a major risk and even smokeless tobacco products contain a variety of toxins associated with cancer. Smokeless tobacco can also irritate your gum tissue.

Giving up smoking will provide a significant boost to your oral health as well as giving you the chance to live longer.