Problems with dental care?  Quest, the magazine for the MDA Foundation, had a great article by Bill Greenberg with tips and ideas on how to maintain good oral health in people with neuromuscular disease and other disabilities.   Tips include special toothbrushes, finding a dentist, and treating trismus.

Maintaining your oral health is extremely important.  Bad oral health of your gums and teeth can lead to infection, pain, eating and dental problems, and even heart attacks.  If you have swallowing problems or dry mouth, you are especially at risk of oral and dental problems.  Difficulty in swallowing or dysphagia can leave food and liquids in the mouth, which increases the risk for tooth decay and gum disease.  Saliva protects the teeth, so a lack of saliva from dry mouth (xerostomia) can further cause oral health problems.

Another issue that can cause problems is a limited opening of the mouth, or “trismus.”  Trismus is often caused by radiation for head and neck cancer, trauma, tissue contractures, or post-surgical scarring.   If you have a hard time opening your mouth, there are aids to help stretch the mouth open, allowing for brushing and dental work.  The OraStretch press and TheraBite are devices with squeeze handles that push the mouth open to stretch out the tissues for a wider opening.  

The most important key to good oral health begins with daily brushing and flossing at home.  If you or a caregiver have problems brushing there are some specialty bushes like the Surround toothbrush and the Collis-Curve Brush for better care.  And for those at increased risk of dental and gum disease, fluoride can be used to prevent tooth decay.  One fluoride option is a prescription dental rinse called chlorhexidine, under the brand Peridex.  

Finding and seeing a dentist is also an important part of your oral health. Finding a dentist can be hard, but many states have a director of dentists with expertise in working with special needs patients.  Visiting every six months is a good beginning timeframe to your dental health.  

Dentists treating special needs patients should coordinate with the patient’s physician and make sure to get a list of medications.   Steven Perlman, a specialist for dental health for people with disabilities, advises to “Treat them like any other normal, healthy, intelligent patient that you have in your practice," he says. They may take a little longer or require a dental prop, but the dentistry is the same.  

To read the full article “Open Wide and Say 'Ahhh...' visit the Quest website here.


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