Good Oral Hygiene at Home for Caregivers and Their Loved Ones

First things first, oral health is connected to overall health. We call it the Mouth-Body Connection, and it is an essential concept of whole-body health.

That’s because what happens in your mouth can affect the rest of the body. When you have an infection or inflammation in your mouth, the disease-causing pathogens can permeate into the bloodstream and travel throughout the body. When this happens, the body has to devote resources to fighting off inflammation in the oral cavity, decreasing its ability to fight it off in the rest of the body.

Good news is that gum disease and other dental diseases respond well to preventative care. Valuing your oral hygiene at home is essential – your smile will thank you. And a helpful tip: keeping teeth clean above and below the gums helps control the bacteria levels in the oral cavity.

Making healthy food choices is also critical. Understanding sugars, starches, and acid provide an environment in the mouth where bacteria thrive can help with nutritional decisions.

Hydration is essential to keep saliva production where it needs to be. Some medications can dry out the mouth, so ensuring proper fluid intake can help prevent any adverse effects on the oral cavity.

Having improved oral hygiene has excellent benefits. First, it improves one's self-esteem – a healthy mouth gives everyone plenty to smile about. By preventing gum disease, one avoids the poor effects.

Reducing the chances of infection and poor oral health begins with consistent dental hygiene, which includes:

• Brushing for two minutes twice a day with fluoride toothpaste 
• Flossing at least once a day
• Consuming more fruits and vegetables and other nutrient-dense foods
• Avoiding sugary drinks or foods
• Not smoking or chewing tobacco
• Drinking fluoridated water
• Seeing your dental team at least twice a year

Let's take a closer look at what appropriate tooth brushing technique includes.

Most people already know how to brush their teeth — or they think they do. There are  three steps to remember:

• Use the toothbrush at the gum line at a 45-degree angle. With gentle pressure, brush the teeth up and down or in small circles. 
• Brush all the teeth. Start with the top teeth, then brush both front and back, include all chewing surfaces for approximately two minutes. 
• Don't forget the tongue. The tongue is where bacteria can hang out, so be sure to brush it.

If you brush a loved one's teeth and cannot see the gumline or teeth, try using a spoon to retract the patient's cheek. It is not a good idea to clean teeth without seeing where you are brushing because you can hurt the patient's gums. For patients with limited dexterity, try placing the bristles on the teeth and rotating the wrist so the toothbrush "rolls" across the contours of the teeth or close the teeth and use a sweeping circular motion that gets the teeth using slight pressure. 

Do not be afraid to ask if you need help with what would work best for your situation. Your dentist or hygienist can recommend a technique that will work for you and demonstrate how to do it. 

Flossing is every bit as important for your teeth as brushing. And it can be challenging for people who have problems with dexterity or intellectual disabilities. Don't be afraid to step in and do it for them. 

• Get 18 inches of floss. Wrap the floss around each index finger. 
• Grab the floss between your thumb and forefinger of both hands. Make a ½ inch section that you hold taught. Gently work that between the teeth and pull it up to the gum.
• Make a c-shape around the tooth. Slide it down the tooth and repeat for each tooth. Make sure that the pressure is on the tooth and not the gums.

If dexterity is a problem, you can try floss holders. Interproximal brushes might work, too.

Rinsing is an excellent step in a homecare routine. The extra fluoride is ideal for the teeth and can help prevent decay. 

• Get a capful of a fluoride rinse. Your dental professional may prescribe a prescription
• Tip the rinse in the mouth and swish. Keep it up for 60 seconds. 
• Spit. Do not swallow the rinse.
• Do not eat or drink for 30 minutes. This time allows the fluoride rinse to do what it needs.

If the patient cannot swish the rinse without swallowing, gagging, or having problems spitting, you can apply it directly to the teeth with a cotton swab or toothbrush. Also, your dental care team might suggest a fluoride gel treatment instead of a rinse. 

In some cases, the dental team might prescribe a chlorhexidine gluconate product to treat red, swollen, or bleeding gums typified by early-stage gum disease called gingivitis. If that is the case, use the product with a sponge applicator or toothbrush on the teeth and gum. Best to use it 45 minutes before or after fluoride products because fluoride counteracts the effects of chlorhexidine gluconate. 

When patients cannot brush themselves because they cannot hold a toothbrush, it's tempting to give up. Luckily, there are ways to modify the toothbrush. Here are a few ways that can help. 

• Band it: You can use a wide elastic band to attach the toothbrush to the patient's hand. But not too tight; you want the band just tight enough to keep the brush there without cutting off circulation.
• Bend it: Sometimes, when the composition of the toothbrush allows for it, running it under boiling water makes it possible to bend it at a different angle. The new angle might be better for the patient to manage the brushing autonomously.
• Extend it: Making the handle longer might help when the patient cannot raise their arm. Some things that might help are to secure a wooden spoon or ruler to the toothbrush handle. 
• Grip it: If the problem is the patient cannot grasp the handle, adding some volume to the handle might help. For example, putting the handle inside a sponge or bicycle handle grip might provide enough circumference for the patient to grab the toothbrush securely.
• Prop it: In cases where the person cannot hold their mouth open long enough to brush their teeth, propping the mouth open with something can help. You can use a moistened and rolled-up washcloth as a prop or tongue depressors taped together. 
• Buy it: Specialty toothbrushes have multiple brush heads, which can help some patients brush. In addition, electric toothbrushes might be able to get the job done for some patients, too. 

For patients with physical disabilities, brushing their teeth for them might be necessary.  And depending on their immobility, it might require you to get into a position for it. Here are a few to consider.

• On the bed: Have the patient lie down with their head in the caregiver's lap. The caregiver should then support the patient's head and neck with their arm while the caregiver brushes the patient's teeth. This support also works on the sofa.
• In a chair: Good to note, it’s not just any chair. A beanbag chair might give a patient, who has trouble sitting up straight, the feeling that they can relax. Use the same positioning for the head and neck as the bed or sofa position.
• From the floor: There are two positions. First, the patient can sit on the floor while the caregiver sits behind them on a chair and has the patient lean their head on the caregiver's knees. Second, have the patient lie down with their head on a pillow. Then, kneel behind and brush their teeth. Remember, supporting the person's neck and head in these positions is imperative.   
• Behind the wheelchair:  Caregivers can stand or sit behind the wheelchair and brush the patient's teeth from behind them. If the wheelchair remains upright, the caregiver should use their arm to brace the patient's head against the back. If the wheelchair is tilted back into the caregiver's lap, the caregiver should lock the wheels for safety before reclining the patient.

Maintaining your oral health is essential, not only for a whiter, brighter smile, but also for your overall health. We are proud to partner with the Special Olympics and we hope these suggestions are helpful for you and your loved ones. However, this article in not intended to serve as a substitute for regular care from your dental professional team. Athletes should see their dental teams at least twice a year for regular cleaning and checkups. These visits will help guide necessary adjustments to home care practices and reinforce the concepts behind keeping your oral cavity, and everything connected to it, as healthy as possible.

Need to visit a Smile Generation-trusted practice for dental care? Use our Find a Dentist tool to find a practice nearby for you or someone you love.

Special Olympics is a global inclusion movement using sport, health, education, and leadership programs every day around the world to end discrimination against and empower people with intellectual disabilities. Founded in 1968 and celebrating its 50th Anniversary, the Special Olympics movement has grown to more than 6 million athletes and Unified Sports partners in more than 190 countries. With the support of more than 1 million coaches and volunteers, Special Olympics delivers 32 Olympic-type sports and over 100,000 games and competitions throughout the year. Special Olympics is supported by individuals, foundations, and partners, including Bank of America, the Christmas Records Trust, The Coca-Cola Company, ESPN, Essilor Vision Foundation, the Golisano Foundation, the Law Enforcement Torch Run for Special Olympics, Lions Clubs International, Microsoft, Safilo Group, Stavros Niarchos Foundation, TOYOTA, United Airlines, and The Walt Disney Company.

Learn more at www.SpecialOlympics.org.