Transcript Healthy Mouths for Kids under 5

Healthy Mouths for
Dependent People
Outcomes
•Why good oral health is important.
•Recognise the factors that contribute
to poor oral health.
•Confidently carry out daily oral care.
•Know when to report any oral health
concerns.
•Be able to carry out an oral health risk
assessment.
•Understand what strategies can help
those who resist oral care.
The Challenge for the Elderly
• Lack of dexterity.
• Health problems – e.g. diabetes, heart.
• Medication - dry mouth, high sugar content.
• Mental Deterioration – poor cognitive skills, memory.
• Stroke –
facial paralysis
slurred speech
difficulty in swallowing
difficulty in understanding.
• Mobility – getting to dentist.
Leads to
• Can’t clear food -> rampant dental decay.
• Link with oral hygiene and
aspiration pneumonia.
• Brushing more difficult.
• Communication more difficult.
• Poor nutrition.
• Difficulty with dentures – chewing.
• Food pooling on side of paralysis in stroke.
• Sip feeding increases decay.
We’ll be looking at…
Tooth decay.
• What it looks like
• What causes it
• How it can be prevented
How to look after someone else’s teeth – toothbrushing.
How to look after someone else’s mouth.
Healthy Eating.
Oral Health is Paramount
• Infections
• Prevention of pain
• Adequate nutrition
• Ability to speak
• Ability to express
emotion
3 steps to keep the mouth healthy
• Brush twice a day with
fluoride (1450ppm) toothpaste.
• Keep sugary snacks and drinks to mealtimes.
• Have a dental check-up at least every year.
Tooth decay …
…is one of the most common diseases;
…it can be stopped.
How Teeth Decay …
• There are millions of GOOD
and BAD bacteria in our
mouths.
• The bad bacteria in plaque
eats the sugar and changes
it into acid.
• The acid damages the
enamel on the teeth.
• Which then causes decay
(caries) or holes (cavities)
in our teeth.
What can cause tooth decay?
• Frequency of eating
and drinking lots of
sugary snacks and
drinks.
• Not brushing teeth
twice a day with
fluoride toothpaste.
Effect of sugar on the teeth
(Acid levels in the mouth over 24 hours)
11
12
A M
10
11
1
2
4
8
7
6
Morning
5
2
3
9
4
8
7
Acid
Neutral
1
P M
10
3
9
12
6
Afternoon
5
Eating Pattern Bad for Teeth
(Acid levels in the mouth over 24 hours)
11
12
1
A M
10
11
2
8
4
7
6
5
3
8
4
7
Neutral
2
9
6
Acid
Morning
1
P M
10
3
9
12
Afternoon
5
Healthy Snacks
Bread
Fruit
Breadsticks
Crackers
Vegetables
Sandwiches
Drink well
• When it comes to thirst…drink tap water first!
• Encourage water as only night time drink.
• Avoid sugary drinks in-between meals.
Drinks that damage their teeth
Gum Disease
Can be caused by…
• the build up of plaque.
• lack of brushing.
• Smoking.
It is divided into:
• Gingivitis.
• Periodontitis.
Gingivitis
• Early stage gum disease.
• Gums become red,
swollen and bleed when
brushed.
• Some people suffer from
bad breath.
• Reversible.
Periodontitis
• Advanced stage with
supporting bone
destroyed by plaque
under gum.
• Teeth become loose and
can be lost.
• This can affect eating,
speaking and quality of
life.
• Loose teeth can be
inhaled.
What might help
• Oral health assessment – dietary analysis, risk
of decay or gum disease.
• Self care - Individual’s ability or level of
dependence for oral hygiene.
• Electric brushes to aid cleaning.
• May need help to maintain oral hygiene.
• Consider oral side-effects of medication.
Routine Mouth Care
• When possible, teach and encourage self care.
• Use torch when examining mouth.
• Wear non-latex gloves.
• If dental treatment required, ask for home visit.
• May often be unrewarding and difficult.
• Provide as much as patient can tolerate.
• Prevents sore mouth and permits comfortable
eating, drinking and speech.
How to clean
• Take out dentures.
• If necessary insert a mouth prop.
• Brush all surfaces using fluoride
toothpaste > 1450ppm or corsodyl gel
at least twice daily.
• Floss or use tepes between teeth.
• Use chlorhexidene if appropriate.
• Gently clean rest of mouth and lips using
damp gauze.
Steps for brushing
•
•
•
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Wear non-latex gloves.
Seat the resident and stand behind them.
Remove partial dentures.
Support head, draw back lips with thumb and
fingers.
• Use small-headed, medium toothbrush and
> 1450 ppm fluoride toothpaste.
• Brush two or three teeth at a time, also the gums.
• Allow the resident to spit out and rinse brush.
Flossing
• For getting in
between the teeth
where the tooth brush
does not reach.
• Reduces the chances
of decay in between
teeth and gum disease.
The result of poor oral hygiene
• Decay – especially root decay.
• Use brushing, flossing, mouthwash,
fluoride.
• Gum disease – poor OH, Smoking.
Dry mouth
• Altered taste, difficulty in chewing,
retention of dentures.
• Increased risk of infection.
• Increased risk of decay – root caries.
• Most common causes are prescribed drugs.
• Switch to a sugar free alternative– get GPs advice.
• Drink water frequently, chew SF gum.
How to manage dry mouth
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•
•
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Ask patient if lips feel dry or uncomfortable.
Ensure soft tissues are kept clean.
Provide liquids – water, ice, artificial substitutes.
Ensure sugar free lubrication.
Denture Care
• Dentures should be brushed twice daily.
• Clean dentures over filled sink with unperfumed
soap and rinse thoroughly in running water.
• Check them for cracks, sharp edges or missing
teeth.
• Dentures should be left out at
night and soaked in water for plastic.
• Metal dentures can use chlorhexidene.
• Mark with owner’s name.
Denture wearing problems
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•
•
•
Assist in chewing and swallowing.
Fixative.
Especially stroke.
May need dental advice.
Soft tissues
Tongue – black hairy
geographic tongue.
Needs to be kept clean.
Ulcer – due to dentures rubbing.
Contact Dentist.
If dry, clean with damp gauze and protect.
Angular cheilitis – redness, cracks or crusting.
May be fungal and / or bacterial.
Candida infection – redness under denture
white plaque.
Oral Cancer
• Oral cancer is twice as common among
males.
• Beware white, red or speckled patches.
• Ulcers or sores that do not heal within 14
days.
• Lumps in mouth or lip.
Risk factors: People who smoke and drink alcohol heavily.
Cancer on lips can be result of exposure to sun.
Uncooperative Patients
• Be caring and calm.
• Position yourself at the same eye level, from the
front.
• Simplify any instruction and praise when completed.
• Can demonstrate, guide hand, distract or try
someone else.
Guide to a Healthy Mouth

Good brushing twice a day
with fluoride toothpaste

A good balanced diet

Regular care for the less able
 The healthier your teeth are
the happier you will be!