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.

The difference between canker sores and cold sores

Although canker sores are often confused with cold sores, there is a difference.

Canker sores occur inside the mouth, and cold sores usually occur outside the mouth.

Canker sores are small ulcers with a white or gray base and a red border. There can be one or more sores in the mouth. They are very common and often recur.

They usually heal in a week or two and rinsing with antimicrobial mouthrinses may help reduce the irritation.

Cold sores – also called fever blisters – are composed of groups of painful, fluid-filled blisters that often erupt around the lips and sometimes under the nose or chin.

Cold sores are usually caused by herpes virus type I and are very contagious. They usually heal in about a week.

Over-the-counter topical anesthetics can provide temporary relief and prescription antiviral drugs may reduce these kinds of viral infections.

How your oral health links with your general health

Research has shown strong links between periodontitis (advanced form of gum disease) and other health problems such as cardiovascular disease, stroke and bacterial pneumonia.

And pregnant women with periodontitis may be at increased risk of delivering pre-term and/or having babies with low birth weight.

However, just because two conditions occur at the same time, doesn’t necessarily mean that one condition causes the other. The relationship could work the other way.

For example, there is evidence that diabetics are more likely to develop periodontitis and have more severe periodontitis than non-diabetics.

Alternatively, two conditions that occur together may be caused by something else.

In addition, people who smoke or use alcohol have a higher than average risk of developing periodontitis and other conditions, including oral cancer.

Research is looking at what happens when periodontitis is treated in individuals with these problems.

The aim is to find out whether periodontitis does have an effect on other health problems.

If one caused the other, improvement in periodontal health would also improve other health problems.

While the research is not yet conclusive, the potential link between periodontitis and systemic health problems, means that preventing periodontitis may be an important step in maintaining overall health.

In most cases, good oral health can be maintained by brushing and flossing every day and receiving regular professional dental care.

Why your routine dental cleaning is not routine

For many patients, the dental cleaning appointment may seem little more than a more complicated version of brushing your teeth.

However, this appointment plays a crucial role in patient education and prevention of dental disease.

The appointment is called a “dental prophylaxis,” or “prophy” and it’s one of the most important steps in your dental care program.

Here are some of the elements that it may include, depending on your needs:

– Oral hygiene evaluation

– Tooth brushing and flossing instructions

– Scaling above the gum to remove plaque and tartar

– Debridement of tartar beneath the gum

– Polishing the teeth

– Periodontal charting

It’s important to remove plaque from the teeth as it ultimately forms a hard, rough sediment known as tartar or calculus, which must be removed by a dental professional to help prevent periodontal disease.

Polishing the teeth removes stains and creates a feeling of fresh breath and a clean mouth.

The hygienist or dentist may recommend a prophylaxis visit every two to six months.

Although insurance may only cover two prophies a year, recall frequency depends on many factors and should be based on individual needs.

These appointments can help you have much better dental health and could save you a great deal of time and money in the long run.

The facts about oral cancer

Oral cancer is not as well known as other types of cancer but it can represent a life-threatening risk if not identified early.

– It strikes an estimated 35,000 Americans each year
– More than 7,500 people (5,200 men and 2,307 women) die of these cancers each year
– More than 25% of Americans who get oral cancer will die of the disease
– On average, only half of those diagnosed with the disease will survive more than five years
– African-Americans are especially vulnerable; the incidence rate is 1/3 higher than whites and the mortality rate is almost twice as high

Although the use of tobacco and alcohol are risk factors in developing oral cancer, approximately 25% of oral cancer patients have no known risk factors.

There has been a nearly five-fold increase in incidence in oral cancer patients under age 40, many with no known risk factors.

The incidence of oral cancer in women has increased significantly, largely due to an increase in women smoking. In 1950 the male to female ratio was 6:1; by 2002, it was 2:1.

The best way to prevent oral cancer is to avoid tobacco and alcohol use.

Unusual red or white spots can form in and around the mouth. These are often harmless but they can be cancerous or pre-cancerous.

Identifying and removing these early enough is a major factor in reducing the incidence of cancer.

So knowing the risk factors and seeing your dentist for regular examinations can help prevent this deadly disease.

How Osteoporosis medications can affect your dental health

Osteoporosis is a disease that weakens bones and increases the risk of fractures.

It affects about 10 million Americans – of whom 8 million are women – and another 34 million are at risk of developing it.

So this is a disease that affects more women than cancer, heart disease and stroke combined.

But what does it have to do with your dental care?

Well, many people in these categories are treated with a group of prescription drugs called oral bisphosphonates. Studies have reported that these drugs reduce bone loss, increase bone density and reduce the risk of fractures.

But some people have been alarmed and confused by recent news reports about oral bisphosphonates because of uncommon complications that have been linked to these drugs.

The drugs have been associated with osteonecrosis of the jaw (ONJ), a rare but potentially serious condition that can cause severe destruction of the jawbone.

The true risk posed by oral bisphosphonates remains uncertain, but researchers seem to agree that it appears very small.

Given the risks associated with osteoporosis and the proven benefits of oral bisphosphonate therapy, you should not stop taking these medications before discussing the matter fully with your physician.

If your physician prescribes an oral bisphosphonate, it’s important to tell your dentist so that your health history form can be updated.

In this case, some dental procedures, such as extractions, may increase your risk of developing ONJ, so your dentist needs to be able to take your full health picture into account.

What is plaque and how does it affect your teeth?

Plaque is a sticky film of bacteria that covers our teeth and, when we eat something, these bacteria release acids that attack the tooth enamel.

When these attacks are repeated over time, the enamel will break down and this will eventually lead to cavities.

When plaque is not removed through daily brushing and cleaning it hardens into calculus or tartar. When tartar collects above the gum line, brushing and cleaning between the teeth becomes more difficult.

The gum tissue can become swollen or may bleed. This is called gingivitis and it is the early stage of periodontal (gum) disease.

There are several steps you can take to protect yourself against this happening:

– Brush your teeth twice a day with fluoride toothpaste
– Clean between teeth daily with floss or an interdental cleaner
– Eat a balanced diet and limit the number of snacks between meals
– Visit your dentist regularly for professional cleanings and oral exams
– Ask your dentist about sealants – these are protective coatings that can be applied to the back teeth where decay often starts.

If you take steps to remove the plaque each day, you have a greater chance of avoiding tooth and gum problems.