ASK KELLY: ORAL HEALTH AND DENTAL CARE
A few months ago – pre Covid-19, I outlined some information on dysphagia and drooling. Maintaining oral health can be challenging for people who have CP, for many reasons, which I’ll discuss in this month’s edition of Ask Kelly.
I’ve previously looked at why people with CP can have challenges with drooling and swallowing. These challenges include;
difficulty swallowing (dysphagia)
bite misalignment (malocclusion) and
issues with muscle tone and control of neck/trunk.
Oral health issues are more prevalent for people with CP and they can be in direct relation to the above factors, or due to a range of challenges.
Oral health challenges for people with CP can arise from:
Trouble chewing or moving food in a backwards motion when eating
Not being able to eat orally
Gagging/vomiting and/or having reflux
“Pocketing” food in the mouth or food staying in the mouth for long periods of time
The impact of some medications
Mouth, tongue, cheek biting
Having mouths often/always open
Misaligned bite (malocclusion)
Difficulty in attending to oral hygiene
Oral sensitivity/aversion/sensory challenges
These issues can result in decay, weakened enamel, gingivitis, bad breath, mouth sores/ulcers and/or damaged teeth.
How can oral health be attended to?
There are special toothbrushes available as well as different ways to adapt brushes/handles to assist the individual to better manipulate them and clean all teeth surfaces.
There are also tips/adaptations for carers who assist or attend to others in flossing/brushing.
An OT can provide an individualised assessment and plan/aides for attending to oral hygiene.
For those who take all their food/fluids via a PEG, it’s important to ensure that all areas inside their mouth as well as their lips are regularly moistened/lubricated. This will help with gum health, bad breath, and overall comfort. People who cannot safely eat or drink orally, still require regular brushing and flossing.
What dental services are available for individuals with CP?
The department of health provides dental services through SDS schools and dental visits for those who are home-bound (requires a referral) – details and contacts can be found here.
The Australian Dental Foundation provides special needs dental care and education at clinics or in homes/residential care settings.
Dr Helen Marchant provides onsite and mobile dental care – Western Special Needs Dentistry
Dr Charmaine Hall provides special needs dental care specifically for children – Smile Solutions
Dr Kerrie Punshon and Dr Warren Shnider provide special needs dental care – Blackburn Dentists Gordon Crescent
More information, tips and advice can be found here:
Australian and New Zealand Society of Paediatric Dentistry
Australian Dental Foundation
Supporting Every Smile