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Oral Health Care for Individuals with Developmental Disabilities

Oral Health Care for Individuals with Developmental Disabilities. Tools and Techniques for Providers and Caregivers. Modifications may be required due to:. Limited ability to understand Behaviors that may interfere with treatment Lack of control over muscle movements and position

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Oral Health Care for Individuals with Developmental Disabilities

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  1. Oral Health Care for Individuals with Developmental Disabilities Tools and Techniques for Providers and Caregivers

  2. Modifications may be required due to: • Limited ability to understand • Behaviors that may interfere with treatment • Lack of control over muscle movements and position • Adaptive devices (such as wheelchairs and gastric or breathing tubes) • Multiple medications • Complex medical conditions

  3. Importance of Oral Health Care • Key component of general health and well being • Affects behavior and behavioral changes • Also affects: • Appearance • Speech • Comfort • Chewing • Nutrition • Breath

  4. Healthy Gums Coral Pink Gums Knife edged papillae Normal pigmentation

  5. Unhealthy gums Gingivitis Periodontitis Swollen, shiny, red gums and gum loss Puffy, red gums

  6. Unhealthy gums • Bleed easily • Are puffy or swollen • Are very red • May shrink away from the teeth making the teeth appear longer • May be draining pus • Usually appear covered with plaque and food particles

  7. What Causes Gum Disease? • Poor oral hygiene and failure to remove bacterial plaque and food debris from teeth and gumlines. • Oral bacteria • Medications that : • Cause dry mouth (lack of saliva) • Cause gum overgrowth • Have high sugar content that promote plaque build up

  8. Healthy Teeth

  9. Three Steps to a Healthy Mouth 1. Brush every day - twice a day 2. Floss every day – at least once a day if possible. 3. Visit a dentist regularly

  10. Providing Oral Hygiene • Make Home Care Routine • Same time • Every day after breakfast and before bedtime • Same place • Bathroom • Kitchen table and chair • Bed (elevate head of bed 30 degrees) • Bean bag chair • Wheelchair

  11. Positioning Yourself Tips for homecare: • Stand behind the person. • Additional support may be gained from standing against a wall. • Use one arm to cradle the person’s head against your body. • Use the other arm and hand to brush the person’s teeth.

  12. Illustrations

  13. Providing Oral Hygiene • Make sure soft bristle tooth brush, tooth paste and floss are easy to reach. • Change toothbrush every three months or more frequently as needed. • Have a cup or basin available for rinsing and spitting if possible. • Have a towel available. • Provide adequate lighting and a mirror.

  14. Providing Oral Hygiene • Use “tell, show, do” method: • Tell: person what will happen • Show: what you are going to do. • Do: begin oral hygiene • Be creative: have a favorite toy or music available to comfort person • A person with impaired senses may benefit from smelling, tasting, and touching toothpaste, brush and dental floss. • Acknowledge good behavior with positive feedback • Allow time to adjust to dental care and develop trust when working in and around their mouth.

  15. Brushing • Let the person try to brush by themselves first. • Use the hand over patient’s hand technique to guide the toothbrush.

  16. If assistance is needed… • Wash hands and/or put on disposable gloves. • Sit or stand where you can see all of the teeth. • Place pea-sized amount of toothpaste on brush if tolerated by person. If not use water or nothing at all. • Brush front, back, top, and gumline of each tooth in short back and forth strokes. • Gently brush the tongue • Rinse with plain water or wipe with gauze sponge. • Be an active observer and check for unusual changes.

  17. Adapting toothbrushes • Make the handle easier to hold with Velcro, a tennis ball, bicycle grip, tape etc. Toothbrush handle enhanced with tennis ball Plak-vac toothbrush for swallowing difficulties Collis Curve 3 brushing surfaces

  18. Adapting toothbrushes • Power toothbrushes may make cleaning easier. • Take time to help the person get used to using the power brush. • If person is sensitive to toothpaste try different toothpaste flavors such as bubble gum or grape.

  19. Flossing • Cleans between teeth where a toothbrush can’t reach. • Flossing is a tough job that may take a lot of practice. • Many types are available: waxed, unwaxed, flavored, or tape. • If you have trouble try using a floss holder

  20. Flossing • Wash hands and/or put on disposable gloves. • Use a string of floss about 18 inches long. • Wrap the floss around the middle finger of each hand. • Grip the floss between the thumb and index finger of each hand and work gently between the teeth until it reaches the gums. • Do this for every tooth one side at a time.

  21. Rinsing • The dentist or hygienist may recommend a special rinse. • Fluoride rinses help to prevent cavities. • Antibacterial mouth rinses may help to fight gum disease. • For persons with swallowing problems a cotton swab, damp gauze, or toothbrush may be used.

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