Special Needs Guide

8/4/2019 Special Needs Guide

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T a b le 0 1 C o n t e n t sINTRODUCTION 3

GETTING STARTED 4

POSITIONING 5

SHOW Do TELL 6

ADAPTING A TOOTHBRUSH 6

DAILYBRUSHING 7DAILYFLOSSING 8FLOSSING NDS 9

DENTURE GLEANING 10, 1 1VISUALAsSESSMENT 12REGULAR VISITS TO THE DENTIST 13HELPFUL HINTS 14DRY MOUTH 15MEDICATIONS 1 5GONCLUSION 1 5

ORAL CARE FOR PEOPLE WITH SPECIAL NEEDS A C areg iver 's G uid e


3/16

I n t r o d u c t i o n~veryone deserves to have a healthy mouth.People of all ages with special needs requiredaily brushing, flossing, a balanced diet,and regular visits to the dentist to ensureoptimal health.

Oral care can be very challenging,but with planning, patience and time,it can lead to better oral health.

This booklet is designed to helpcaregivers maintain goodoral health for theirclient/family memberwith special needs .

ORAL CARE FOR PEOPLE WITH SPECIAL NEEDS A C areg iver 's G uide


4/16

II

G e t t i n g S t a r t e dl o c a t i o n :A s u i t a b l e l o c a t i o n f o r y o u r c l i e n t l f a m i l ym e m b e r i s t h e f i r s t s t e p t o w a r d p r o v i d i n g o r a l c a r e .D Find a comfortable location with a sink such as thebathroom, kitchen or laundry room.D Have your client/family member sit on a chair, sofa,bean bag, in their wheelchair or lay him or her downwith their head resting on a pillow or a cushion.D Ensure you have good visibility in a well lit area.S u p p l i e s :

Keep necessary supplies within easy reach toothbrush fluoride toothpaste* dental floss glass of water basin non-latex gloves (optional) towel mIrror dental aids clean rolled-up face cloth(may assist in keeping your client/familymember's mouth open)

* I I Y O U r c l i e n t l l a m i l v m e m b e r h a s d i f f i c u lt vs w a l l o w i n g o r s p i n i n g o u t , d o n o t u s et o o t h p a s t e - u s e w a t e r o n lv .



5/16

P o s i t i o n i n gT h ese s te p s w il l h elp t o en su re c o m fo nfo r y o u a n d yo u r c lie n tlfam ily m em b e r :! l o F ind a safe , easy , and com fo rtab lepos i t ion fo r you and you rc lie nt/fam ily m emb e r.

~ P lace yourse lf beh ind or besideyou r c lien t/fam i ly m em b er an dcr ad le th eir h ea d .

~ A sk fo r assistance if you requ ireh e lp to con tro l b ody m o vem e nts .

~ A lw ays lock the w heels o f awh ee lch air a nd tilt ch airb a ck on to you r lap .

~ W hen he~dis t ilted b ack ; y _ ; ; ; :tak e sp ec ia l ca re to ,'.p rev en t ch ok in g f o . ~and /o r gagg in g . "" ,-.. ORAL CARE FOR PEOPLE WITH SPECIAL NEEDS A C areg iver 's G uid e


6/16

S h o w D o T e l lO ra l C are can be frigh ten ing to peop le w ith spec ia l needs. ..These fo llow ing suggestion s m ay he lp reassu re th em :

E xp la in and dem onstra te eachstep to your clien t/fam ily m em ber. H ave a routine for ora l care i.e . C hoose thesam e tim e and p lace every day . M ove in a calm , slow , reassu ring m anner. G ive positiv e feedback to re inforce good behav iou r. G ive your clien t/fam ily m em ber tim e to adjust too ra l care . It takes tim e for a person to tru st som eoneworking in h is o r her m ou th .

A d a p t i n g A T o o t h b r u s hIf t h e c l i e n t / f a m i l y m e m b e r y o u c a r e f o r c a n b r u s h b u t y o un e e d t o a d a p t h i s l h e r t o o t h b r u s h , h e r e a r e s o m e .

T ry an elec tric o r battery-opera ted too thb rush U se a V elcro strap or w ide elastic band to holdthe too thb rush secu re (tak ing care that theband is not too tigh t) E x tend the leng th of a too thb rush hand le bytongue depresso r, a ru ler o r a pain t stir s tick E n large the too thb rush handle by inserting in to a rubberball , a styrofoam ball, a b icycle handle o r foam tubing



7/16

D a i l v B r u s h in g~eryday a sticky film called plaque forms on the teeth.If plaque is not removed by brushing and flossing on aregular basis, it not only causes cavities, but can lead togingivitis and periodontal disease.A two minute brushing twice a day is recommended.If the client/family member you care for is unable to brush,follow these steps:

~ W ash you r hand s tho ro ug h ly ...,P If n eed ed , p ut o n n on -la te x d isp osab le g lo ve s ...,P Sit o r s tand w he re yo u can see a ll su rfa ce s o f th e te e th ...,PU se m a nu al o r p ow er to oth bru sh w ith so ft b ris tle s ...,PU se a p ea -s ize am o un t o f to oth pa ste w ith flu orid e * ...,P P lac e th e b ris tle s a t a 45 d eg ree an gle ag ain st th e g um lin e.~ M ov e th e b ru sh in a sm all , g en tle , c irc u la r m otio n .~ Beg in w ith th e up p e r te e th b ru sh in g ou ts id ein sid e a nd th e c Iie w in g su rfa ce s.~ Rep ea t s tep s fo r th e low er tee th .~ G en tly b ru sh th e to n gu e to rem ov e an y b ac te ria andto fre sh en th e b rea th .~ H elp th e c lien t/fam ily m em be r r in se w ith w ate r.F o r th e c lien t/fam ily m em b er w h o is u nab le to r in se ,

u se a to o thb ru sh d ip p ed in w ate r o r ad isp osa ble O ra l Sw a b ...,P If n ee de d, lu b ric ate th e c lie nt/fa m ily m em b e r's lip so nce b ru sh in g is co m ple ted to h elp p rev en t c rack in go r d rym g lip s ...,PU se cau tio n if requ ired to p lac e yo u r fin g e rs iny ou r c lie n t/fam ily m em ber 's m ou th ...,PU se a n ew too th b ru sh ev e ry 3 m on th s , a f te r a co n tag io u silln ess o r w hen th e b ris tle s a re w orn .

* If vour cllanUfaml1V mambar has dlnlcultvswallOWing or SPIRing out, usa watar onlv.



8/16

D a i l v F lo s s i n gD a i ly f l o s s in g i s r e c o m m e n d e d I t c l e a n s b e tw e e n th e t e e t hw h e r e a t o o th b r u sh c a n ' t r e a ch . M a n y p e o p l e w i t h d is a b i l i t i e sn e e d a c a re g iv e r t o h e l p t h em f l o ss a s r e g u la r l y a s p o s s i b le .

Take a p iece of floss approx im ately 45cm(18 inches) long and w rap it around yourm iddle fm gers until you have no m ore than2 .5 em (1 inch) in leng th betw een them

With the thumb and index finger of each hand,guide the floss gen tly and carefully betw eeneach tooth using a back-and-forth m otion untilit reaches the gum line

Curve the floss in to a C -shape around eachtooth and slip it under the gum line

Slide it up and down the side of the too th

M ove the floss to the side of the neighbouringtooth and repeat

Rem ove the floss in a back-and-forth m otionand repeat the steps fo r each too th

U se a clean section of the floss for each tooth



9/16

F l o s s H o ld e rUsed with regulardental floss

T o o t h F lo s s e rA one-use disposableflosser (multipletooth flossersmay be required)

F lo s s T h r e l l i e rAn aid designed to sq(4)!;thread dentalfloss underbridges and betweencrowns

A b a n e lVp o w e re d l I o s s e r

ORAL CARE FOR PEOPLE WITH SPECIAL NEEDS A C a re giv er 's Guid e


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D e n tu r e C le a n in gS u p p l ie s : T o o t h p a s t e D e n t u re b ru s h

D i s p o s a b l en o n - l a t e x g lo v e s T o w e l f o r s i n k

P r o c e d u r e : P lace tow el in sink and fillV \~ thv vaterap proJcim ately

5 em (2 inches) to prov ide a cushion. D entures canb re ak e asily . H and le w ith care .

With a g loved hand, grip the denture fm nly and beginscru bbing all surfaces o f th e d en tu re w ith th e too th pastean d d en tu re bru sh . B leach or any abra s iv e hou seho ldc lean er sh ou ld n ever b e u sed to c lean den tu res .

Ensure that every surface of the denture is thoroughlyscrubbed free of p laque and food p articles. Rinse w ithlu ke-wa rm wa ter.

If a nightly cleaner like Polident or E fferdent is used,alw ays brush and rinse denture p rior to soaking .

If cleaning a partial denture, ensure that the claspsare gently cleaned. V igorous scrubbing of the claspscould bend or break them causing the partial to fitin co rrectly or n ot at all.



11/16

R em ov e d en tu r e s a t n ig h t . G um s need to re s t.S to re c le an d en tu re s in a con ta in e r o f coo l w a te ro r n ig h tly c le an e r so d en tu re s do no t d ry o u t andb eco m e w a rp ed .

A lw ay s c le an th e c lien t/fam ily m em be r 's to n g u e ,ch eek s an g um s u s in g a so f t b r is tle to o th b ru sho r a d isp o sab le O ra l Sw ab .

T ak e th is o p p o rtu n ity to do a v isu a l asse ssm en tfo r any ch ang es in th e m ou th . If y ou see so resth a t d o no t h ea l w ith in 7 to 1 0 d ay s , y ou shou ldse e a d en ta l p ro fe ss io na l.

T o lo o sen s tu b b o rn s ta in s a n d /o r h a rd ta r ta r d ep o s its ,a 30-m in u te v in eg a r a n d w a te r so a k ca n b e u sed .A com bin a tio n o f 1 /4 cu p o f w h ite v in eg a r a n d 3/4 cu po f ro om tem pe ra tu re w ate r ca n b e p la c ed in a d en tu rec u p to so a k th e d en tu re .D o n o t u se th is c om b in a tio nfo r a p a r tia l d en tu re a s it c a nta rn ish a m e ta l c la sp .E n su re th a t th e d en tu re isrem o ved a fte r th ir ty m in u te sa n d b ru sh ed th o ro ug h ly torem ove a ll tra c e s o fv in eg a r a n d to b ru sh o ffa ll lo osen ed ta r ta r .

_ -



12/16

V i s u a l A s s e s s m e n tQ9/ v isua l assessm en t shou ld be done a t least once a m on th toe nsu re th at th ere a re n o a bn orm a litie s. It is im p ortan t to observ ea ll th e areas o f the m ou th inc lud ing the lip s , tongue , under thetongue , th e roo f o f the m ou th , in side the cheeks, the gum s andth e te eth .D o cum en t an d in fo rm th e ap pro pria te p erson if any th ing abn orm a lis o b se rv e d . It is im portan t to rem em ber tha t m any o ra lab no rm a lities in clu din g o ra l can cer can b e p resen t w ith little o rno pa in . If you r c lien t/fam ily m em ber has a lim ited ab ility tocomm unica te , you m ay no t know o f any o ra l d iscom fo rt un less av isua l assessm en t is p erfo rm ed . Y ou m igh t w an t to ask if thec lien t/fam i ly m ember is h av in g d ifficu lty ea tin g o r ch ew in gc erta in fo od .L o o k f o r a n v o f lh e fo llo w i n g :( . : : : ; > Broken o r loo se tee th( . : : : ; > D ry , cracked , sw ollen o r b lis te red lip s( . : : : ; > Redness , sw elling , irr ita tion , so res o r w hite p a tches in th e m ou th( . : : : ; > C av itie s (d ark spo t o r ho le on too th )( . : : : ; > A bscesse s (pu s pocke t o r bum p on gum )( . : : : ; > Bleed ing , sw elling o r redness o f th e gum s( . : : : ; > Lum ps and bum ps( . : : : ; > C oa ting o f th e tongue and m ou th (any d isco lo ra tion )( . : : : ; > T i ss u e d is c ol or atio n( . : : : ; > Breath scen t (som e scen ts can be sym ptom atic o f anu nd erly in g m e dic al c on ditio n)( . : : : ; > Watch fo r chang es in and around th e m ou th and face



13/16

R e g u la r V i s i t s T o T h e D e n t i s t8 ! / o u r c lie nt/fam ily m emb er sh ou ld h av e reg ula rd e n ta l a p poin tmen t s.P ro fessio na l c lean in gs are ju st asim p o rtan t a s b ru sh in g an d flo ss in g e very day .Once you find a den tis t w ith w hom you arecom fo rtab le a nd co nfid en t, it is essen tia l th aty ou m a in ta in reg ula r v is its .R eg ula r e xam in atio ns can id en tify p ro blem s b efo reth ey cau se u nn ecessary p ain .

Itm ay take tim e fo r the c lien t/fam ily m em ber to becom ecom fo rtab le a t the d en ta l o ffice . A first v isit to m eet th e den ta lteam and fam ilia rize w ith the o ffice can m ak e subsequen tv is its e as ie r.

A n updated m ed ica l h isto ry inc lud ing a lis t o fa ll m e dica tio ns h e/sh e is tak in g an d a ll k now n alle rg ies

shou ld be g iv en to the d en tis t.A ssessm en t o f the so ft and hard tissue , x -rays,sc alin g , p olish in g , flu o rid e tre atm e n ts , se ala nts a ndres to ra tio ns are a few ex am p les o f d en ta l p ro ced ures.T he den tis t m ay also suggest a fluo ride rin se to red ucedecay if needed o r p rescribe an o ra l rin se to he lp inred uc in g in flamm a tio n (red ness) an d sw e llin go f the gum s .



14/16

ORAL CARE FOR PEOPLE WITH SPECIAL NEEDS A C areg iver's G uide


15/16

D r v M o u t h :%m ou th (X e ros tom ia ) is a sym ptom o f ce rta in d iseases o rm ay be cau sed by the use o f m ed ica tion s o r rad ia tio n trea tm en to f th e h ead and neck . T he lack o f sa liv a can affec t nu tritio nand sw allow ing . T his can con trib u te to too th decay ,g um d isease o r o ra l in fe c tio n s. In c reasin g w ate r in tak e o r u s in gartific ia l sa liv a p roduc ts m ay ease the d iscom fo rt o f d ry m ou th .If y ou are ex perien cin g dry m ou th m ake su re you see you rd en ta l p ro fessio n a l on a reg u la r b as is .

M e d i c a t i o n s :~ m ed ica tio n s have s id e e ffec ts . M any m ed ica tion s m ayreduce th e flow o f sa liv a cau sin g d ry m ou th . Som e m ed ica tio n shave h ig h sug ar con ten t and m ay cause too th decay .O th er m ed ica tion s th a t a re le ft to d isso lv e in the m ou th cancrea te an ac id ic env ironm en t th a t con trib u tes to too th d ecay .R in s in g th e m ou th o r b ru sh ing th e tee th a fte r each doseis recom m ended . Som e se izu re m ed ica tio n can causeen la rg ed gum s. T his ov erg row th o f g um tissue can be uns ig h tlyand in c rease th e ch ances o f to o th d ecay .

C o n c l u s i o nT h is b o o k le t d o e s n o t t a k e th e p l a c e o f r e g u la r v i s i t sto th e d e n t i s t . P r o f e ss io n a l c le a n in g s , r e g u la r e x a m i n a tio n s ,d a i l y b ru s h in g a n d f l o s s in g w i l l a s s i s t y o u r c l i e n t l f a m i l ym e m b e r in r e a c h in g h i s o r h e r o p t im a l o r a l h ea l th .



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T h e D u rh a m R e g io n H e a l th D e p a r tm e n t , O r a l H e a l th D i v i s io nw o u l d l i k e to th a n k th e D u r h a m O n ta r io D e n ta l S o c ie ty a n d th eD u r h a m H y g ie n e S o c ie ty fo r th e i r g e n e r o u s c o n tr ib u t io nto w a r d th e d e v e lo p m e n t o f th i s r e s o u r c e .F or m o re in fo rm a tio n , p le a se co n ta c tD u rh am Reg io n H e a lth D ep a r tm e n t,O ra l H e a lth D iv is io n a t905-723-1365www . r e g i o n . d u r h am . on . c aThis brochure was produced as an educational service by:

OralHealth~~ENT Division
http://www.region.durham.on.ca/http://www.region.durham.on.ca/

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Special Needs Guide