Dental care

Key facts

People with intellectual disability are at high risk of dental disease. And poor dental care and mouth hygiene can lead to other health problems.

People with intellectual disability should be taught and encouraged to brush their own teeth and gums. Families and support workers need training on how to support people with dental care.

For some people, you may need to brush their teeth and this can be difficult. You may need advice on how to brush a person’s teeth.

Dental care at home

A healthy diet is a good start to dental care. Sugar free snacks are a good idea. Also, people should drink water after meals.

All people with intellectual disability need to be shown how to brush their teeth and gums correctly. Some people will need lots of training and to be reminded to brush their teeth regularly. People with limited fine motor skills may need brushes with adaptable handles.

Incorrect brushing can cause gum disease. This is painful and the person may then resist having their teeth and gums brushed.

Some people will need family or support workers to brush their teeth and gums. Cleaning someone else’s teeth is quite complex and intrusive. You should get professional advice on how to do it. Making a video of a dentist demonstrating how to brush someone’s teeth can be helpful.

Westmead Centre for Oral Heath has a Smiles for life carer training program and the Sydney Dental Hospital has a Carers Support Program. Unfortunately, these will not always be available. But, here are some key tips on how to keep a person’s mouth healthy:

Have the person in a reclining position when brushing their teeth - turn their head to the side if they are likely to choke.
Brush the teeth and gums twice a day – morning and night. If only once a day is possible, it should be at night, after eating.
Use an electric tooth brush – it is easier to use and cleans better.
Use a three-sided tooth brush.
Brush in small circles along the gum line where the gums and teeth meet.
Use a pea-sized amount of a high fluoride tooth paste - this strengthens the teeth.
Use dental floss or interdent brushes.
Use mouth wash or gel with Chlorhexidene - for the gums one hour after toothpaste.
If necessary, use props to keep the person’s mouth open.
Clean dentures after each meal and leave them in water overnight.

Preventive care at the dentist

Regular check-ups are essential to good dental health. Dentists recommend that people have check-ups every 3 – 6 months.

The dentist should provide preventive treatment like cleaning off plaque and tartar and applying fluoride, as well as filling any cavities.

It is important for dentists to have an accurate dental and medical history. This can be documented in a person’s health record.

Special problems for some people

If people have problems with swallowing, food debris can stay around the teeth and cause decay. Also, people can breathe food into their lungs which can lead to pneumonia.
Saliva helps protect the teeth from decay. Some people have a dry mouth from medication. They can be given saliva substitutes.
Some people have gastric reflux and acid from the stomach gets on their teeth. The tooth enamel will wear away leaving the person with hypersensitive teeth. This problem needs to be identified early as it is complex and expensive to repair.
Some people have a “malocclusion” (protruding lower or upper teeth) and ordinary braces will not always be appropriate. The dentist needs to monitor this.
Some people grind their teeth. The dentist will need to monitor this.
People with Down syndrome are at risk of gum disease.
People who have a heightened gag reflex can be sensitive to the taste of toothpaste or the froth it produces. You can try a toothpaste with low froth or no flavour.

For more information

The Smiles for life training program – contact the Special Care Unit at Westmead Centre for Oral Health on (02) 9845 6766 or (02) 9845 7423

Sydney Dental Hospital Carers Training Program phone (02) 9293 3283 or (02) 9293 3237

Good oral hygiene for adults by Chris Daly
www.australianprescriber.com/upload/pdf/articles/1026.pdf

You might be interested in these fact sheets

Going to the dentist - information on finding a dentist and how to make visits to the dentist go well.
Healthy lifestyles
Personal health records

This fact sheet was written in July 2009.

The fact sheet contains general information only and does not take into account individual circumstances. It should not be relied on for medical advice. We encourage you to look at the information in this fact sheet carefully with your health professional to decide whether the information is right for you.