Oral Hygiene Guidelines

Oral Hygiene Guidelines free pdf ebook was written by on February 12, 2009 consist of 20 page(s). The pdf file is provided by www.dshs.wa.gov and available on pdfpedia since January 26, 2012.

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Oral Hygiene Guidelines pdf




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Oral Hygiene Guidelines - page 1
O ral H ygiene g uidelines P reventing D ental D isease in P eoPle with s Pecial h ealth c are n eeDs Division of Developmental Disabilities Revised January 2007
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Oral Hygiene Guidelines - page 2
c ontents OVerVieW What is the Oral Hygiene Program? ..........................................1-2 How can we find out more? ...........................................................2 resOurCes Community Based Dental Hygienists on Contract .....................3 Support Groups ................................................................................3 general General information ........................................................................4 Checklist for finding the right dental office .................................4 Tips for planning successful dental visits .....................................5 Daily Care Guidelines .....................................................................6 CHildren Preventing dental disease in children with disabilities ..............8 Daily oral care ...................................................................................9 Common pediatric dental problems .............................................9 Growth and development checklist ............................................ 11 adulTs Care and Cleaning of Dentures ....................................................12 deFiniTiOn OF TerMs ....................................... 13 adaPTiVe aids ......................................................... 14
Oral Hygiene Guidelines - page 3
W HaT is THe O ral H ygiene P rOgraM ? The Division of Developmental Disabilities (DDD) has been offering an oral hygiene program on a statewide basis for over twenty years. The Oral Hygiene Program offers training and information regarding the prevention of dental disease and referrals to dental professionals, as appropriate, for people with developmental disabilities. The program is provided at no expense for people with developmental disabilities living in Washington State. DDD covers the cost of subcontracting with dental hygienists in local communities to provide training, education, and toothbrushes. The preventive program offers: Dental education for children and adults with developmental disabilities In-service training for caregivers, families and friends Toothbrush storage check OVerVieW People with developmental disabilities have a high incidence of periodontal/gum disease. The DSHS Medical Assistance Administration pays for an oral prophylaxis/teeth cleaning up to three times per year. Once a person with a developmental disability has been diagnosed with periodontal disease, he/she can have teeth cleaning several times per year depending upon individual need. Dental hygienists licensed in the State of Washington are available to provide preventive oral hygiene care, which can include: Oral Prophylaxis (scaling, curettage, etc.) Oral Evaluation (screening, probing, etc.) Oral Hygiene Instructions Topical fluoride Nutritional Counseling Sealants The training guidelines in this booklet are intended to support individuals, families, and caregivers in improving the oral health of children and adults with developmental disabilities. If you have any questions or need more information on positive behavioral techniques to improve self-help skills, please call the DDD Oral Hygiene Program at 360-725-3455. 1
Oral Hygiene Guidelines - page 4
OVerVieW To assist in dental education, a video is available to check out free of charge for two weeks from the DDD Oral Hygiene Program. The video is also available for purchase. The video has three sections: “Great Gums, Tough Teeth” – a training video for staff working with people with developmental disabilities “Super Smiles”– an educational video for parents and families of persons with developmental disabilities “Crack Down on Plaque”– an educational video for people with developmental disabilities H OW Can We Find OuT MOre ? For assistance in finding dental and oral hygiene information, contact the dental hygienist in your community or contact: Connie Mix Clark, RDH DSHS/Division of Developmental Disabilities Dental Program PO Box 45310 Olympia, WA 98504-5310 360-725-3455 360-407-0955 clarkcl@dshs.wa.gov 2
Oral Hygiene Guidelines - page 5
C OMMuniTy B ased d enTal H ygienisTs On C OnTraCT A current list of community based dental hygienists on contract can be found on the DDD Internet web site at: www1.dshs.wa.gov/ddd/dental.shtml s uPPOrT g rOuPs American Dental Association Special Care Dentistry 401 N. Michigan Ave. 22nd Floor Chicago, Illinois 60611 312-527-6764 scd@scdonline.org resOurCes DECOD - Dental Education for Care of People with Disabilities University of Washington Box 356370 Seattle, WA 98195-6370 206-543-4619 Dental Provider Website www.dental.washington.edu/ disability American Dental Hygienists Association 444 N. Michigan Ave., Suite 3400 Chicago, Illinois 60611 800-243-ADHA (2342) www.adha.org Washington State Dental Association 2033 Sixth Avenue Seattle, WA 98121 PO Box 389 Lynnwood, WA 98046-0389 www.wsdha.com The ARC of Washington 2600 Martin Way East, Suite B Olympia, WA 98506 360-357-5596 www.arcwa.org 3
Oral Hygiene Guidelines - page 6
g eneral i nFOrMaTiOn People with disabilities are often more likely to have dental disease. Regular professional cleanings and dental treatments are important for preventing dental problems. People with disabilities may require more frequent dental visits and cleanings than non-disabled individuals (up to four times per year depending on the person’s needs). The dental professional can advise you about the person’s needs, including nutrition, oral hygiene/ cleaning the teeth at home, and additional protection against decay by using fluorides and sealants, which are very effective against cavities. A daily routine of preventive oral care and regular professional checkups can help a person have good oral health. general C HeCklisT FOr Finding THe rigHT denTal OFFiCe Finding the “right” dental office is important for good dental care. The dental office that you select should be “prevention oriented.” Dental offices usually have a registered dental hygienist who specializes in preventing gum disease and tooth decay. Some dentists are specially trained to treat people with disabilities. Call your local dental society (the number will be in the phone book) for a dentist near you who provides care for people with special health care needs. Before visiting the dental office, you may want to ask some or all of the following questions about accessibility and available assistance: What is the exact location of the office? Is public transportation available? How accessible is the dental office for a person who is in a wheelchair or a hospital bed? Is assistance available if help is needed when arriving or leaving? Make your decisions based on the person’s reactions; the actions of the dentist, dental hygienist, and other personnel in the office; and your level of satisfaction. Does the dentist/hygienist: Allow time for the person to look around and become comfortable? Calm the person by using a pleasant, reassuring voice? Speak in simple language and terms? Introduce actions, instruments, and procedures slowly? Provide motivation for oral hygiene at home? Appear confident in his or her approach with the person? 4
Oral Hygiene Guidelines - page 7
The dental hygienist or dentist should take complete medical and dental health histories on the patient. They need to know if the person is currently under a physician’s care and what medications he or she is taking. The person should then be given a thorough head and neck examination. This exam will include the person’s teeth and gums. X-rays will be taken if necessary. The dental staff should practice infection control precautions for all patients by wearing gloves, protective eyewear, and masks. Before any treatment is started, you should be told what was found during the exam, what treatment will be needed, and approximately how much it will cost. This is a good time to ask questions and voice any concerns. The dentist or hygienist should spend some time during the appointment discussing ways to improve the person’s oral health. This may include techniques for more effective brushing and flossing, nutritional counseling, the use of fluorides and sealants, and the selection of other appropriate dental care products. general T iPs FOr Planning suCCessFul denTal VisiTs M aking aPPOinTMenTs When the office is first contacted, inform the dentist if special considerations are required (e.g. congenital heart problems, wheelchair, fear, etc.). Schedule visits at times when the person is least tired and irritable. Call the office before you leave for your appointment to check the schedule, this can avoid unnecessary waiting. • Arrive on time. Be organized (i.e., maintain an appointment calendar and book listing the names, addresses, and phone numbers of health professionals and services used by the person). Request information about costs and options for payment (e.g., special forms). a T THe O FFiCe Don’t be embarrassed about the person’s disability or special behavior. You have a right to such services. Share your feelings and concern. Provide specific and complete information (list medical problems, medications, special needs). 5
Oral Hygiene Guidelines - page 8
Discuss information, advice, or procedures provided by others (e.g., occupational therapist, speech therapist, medical specialists). Ask questions about terms or procedures that you do not understand. Follow the dentist’s guidelines (some dentists prefer you remain in the waiting room). Provide information about previous actions or procedures which have been successful (or unsuccessful) with the person. d aily C are g uidelines P eOPle are keePing THeir TeeTH lOnger as lOng as a liFeTiMe ! Tooth decay and gum disease are common problems for children and adults. general Normal bacteria that live in the mouth can cause tooth decay, sensitive teeth, and gum disease. The normal bacteria in the mouth uses sugar from the foods we eat as their food, and produce acid as a by-product. This acid destroys the tooth, causing decay and gum irritation (gingivitis). As people get older, their gums recede and the roots are exposed so they can also get decay along the gum line. H and WasHing Hand washing is an important first step in infection control. Thorough hand washing helps reduce bacteria on the hands and prevents contamination. To protect clients as well as caregivers, gloves should be worn while working in another person’s mouth brushing and flossing their teeth. Hands should be washed before putting on gloves. If a person has a cut or an abrasion on the hand, a Band-Aid or first aid tape should be put over the cut before the gloves are put on. Change gloves between every person. Toothbrushing and gumbrushing should occur twice per day, preferably once in the morning and once at night. A small toothbrush with a compact head and soft polished bristles should be used to brush the teeth and gums. The brush and a small amount of toothpaste may be used once per day. At least one other time during the day the gumline (gingival sulcus) should be brushed gently to remove the plaque and stimulate the tissue. Establish a brushing sequence and make small, circular motions along the gumline. 6
Oral Hygiene Guidelines - page 9
s TeP - By - sTeP BrusHing Place toothbrush bristles at the gum line, at 45-degree angle to gums. Press gently and use short strokes with vibrating back and forth, or light scrubbing motion. Reposition brush vertically to clean inside surfaces of front teeth, upper and lower. Start with upper teeth, brushing outside, inside, and chewing surfaces. Do the same for lower teeth. Be sure to brush each tooth. To freshen breath, brush tongue too, as tongue can harbor many bacteria. general The tongue should also be brushed using no toothpaste. Replace your toothbrush every one to three months or as soon as it shows wear. s TeP - By - sTeP FlOssing Take an 18-inch piece of floss and wind it around middle finger of each hand. Or tie ends together in a circle. Grasp floss firmly between thumb and index finger of each hand. Hold half-inch section taut for more control. Work it gently between teeth until it reaches gumline. Curve floss into C-shape around tooth. Slide floss up and down side of tooth gently. Remove floss gently and repeat for all teeth. Take care not to injure gums with floss. Flossing requires some degree of coordination and takes practice. It may help to use a floss holder. Flossing should be done once per day. Plaque is a sticky substance that sticks to the teeth and must be flossed off in the areas the brush cannot reach. Place the floss between two teeth, wrap it around one tooth, then pull the floss along the tooth structure and actually scrape the plaque off. s TeP - By - sTeP rinsing Person takes recommended dose of fluoride rinse (usually a capful), swishes it around mouth for 60 seconds, and rinses out, taking care not to swallow it. If the individual is unable to rinse without swallowing, use cotton swab or toothbrush to place a little fluoride rinse on the person’s teeth. Your dental professional may also recommend a prescription fluoride gel treatment. Topical Fluoride is an important part of daily oral hygiene. After the plaque has been removed from the teeth and gums by brushing and flossing, the teeth should be exposed to fluoride. Rinsing with a fluoride mouthrinse for one minute or applying the mouthrinse along the gumline with a brush can do this. The measured amoun t of fluoride can be put in a cup, then dip the brush into the rinse and apply it along the gumline of all the teeth. A person cannot get too much topical fluoride and fluoride has been found to be helpful in many ways. When fluoride is ingested during tooth development, fluoride becomes part of the enamel and has been found to be more resistant to decay and tooth sensitivity. Topical fluoride also helps resist acid attacks to the teeth and gums by interfering with plaque making acid. There is ongoing research on the additional benefits of fluoride for children and adults 7 (e.g., prevention of osteoporosis).
Oral Hygiene Guidelines - page 10
P reVenTing denTal disease in CHildren WiTH disaBiliTies Every child can have healthy teeth and gums. Children with disabilities are no exception. This information will help you understand dental disease and how to prevent it with proper oral care. It focuses on the particular problems and needs of children with disabilities. Use these simple, step-by-step instructions for helping the child practice daily oral hygiene. Good oral health is an important part of a child’s total health. Children with good, strong teeth are able to chew a wider variety of foods for healthy nutrition. Healthy teeth aid in speech development by helping children make the proper sounds for speaking clearly. And clean, healthy-looking teeth help children look better and feel better about themselves. With all the medical, nutritional, and emotional needs of children with disabilities, it’s hard to find time for proper daily oral care. And getting the child to the dental office can be difficult, too. But preventing cavities and gum disease now is easier than correcting them later. Preventive care can save unnecessary pain for the child plus reduce costly dental procedures. CHildren There are a number of reasons why children with disabilities are more likely to have dental disease. Oral conditions Some genetic disorders or very high fevers in very young children can cause defects in tooth enamel that make the tooth more likely to decay. Congenitally missing teeth and misaligned teeth are frequently seen in children with cleft palates. Gum problems often occur in children with Down Syndrome. Physical limitations Children who can’t chew or move their tongues properly do not have natural cleaning action of the tongue, cheek, and lip muscles. Children with disabilities, especially those with poor motor coordination – from spinal cord injuries, muscular dystrophy, or cerebral palsy, for example – may not be able to clean their own teeth or may not be able to use the usual brushing and flossing methods. Special diets Children who have difficulty chewing and swallowing may often eat puréed foods, which tend to stick to their teeth. Frequent eating of sugary foods or sleeping with a bottle of formula, milk, or juice can increase the chances for tooth decay. Children who need help drinking may drink less fluid than other children, so they don’t have enough fluids in their mouth to help wash away food particles. Medications Medications using syrup or sugar to sweeten the taste can cause tooth decay if they’re taken for a long time. Some seizure medications may cause bleeding or enlarged gums, and excessive gum growth can hamper chewing and speech and lead to gum disease. Sedatives, barbiturates, antihistamines, and drugs used for muscle control may reduce saliva flow. With less saliva, there’s less cleansing action to help protect against cavities. Asprin, taken in large doses, and dissolved in the mouth before swallowing, can provide an acidic environment which fosters decay. Some antibiotics should be prescribed with caution because they can stain or discolor newly erupting teeth. 8 © Johnson & Johnson Consumer Products, Inc. 1989
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