Essential Q&A Guide for Carers on Providing Effective Oral Healthcare

Carers checking elderly lady's oral health

Providing effective oral healthcare for those in our care goes beyond basic hygiene; it profoundly impacts their overall well-being. This guide addresses common questions carers might have regarding oral healthcare, emphasizing its importance, the challenges faced, and warning signs that should not be overlooked.

Why is the Provision of Oral Care Healthcare So Important?

Our mouths play a vital role in daily life, influencing our appearance, speech, and enjoyment of food. For instance, studies show that 70% of people believe oral health significantly affects their self-esteem and social interactions. Good oral hygiene can prevent problems that lead to nutritional deficiencies and other serious health complications, such as heart disease, which has been linked to poor dental health.

By maintaining oral hygiene, we can help prevent infections and pain. For example, individuals with untreated cavities or gum disease may face more extensive health issues that require costly treatments.

Moreover, ensuring that people are comfortable during care can improve their mental and emotional well-being.

Why is it Sometimes Difficult to Provide Effective Oral Health Care?

Despite the importance of oral care, some individuals may resist or refuse it. Past experiences of discomfort may lead to anxiety. This is particularly true for individuals with dementia, where negative feelings associated with oral care often outweigh the need for hygiene.

Research indicates that about 50% of individuals with dementia show resistance to personal care routines. Carers can mitigate this by employing gentle, compassionate techniques. Building trust is key; for example, allowing individuals to hold a toothbrush might help them feel more in control during the process.

For people who need assistance with oral care, how often should this be provided?

• Minimum twice a day: before bed, and at one other time

• We need to ensure we are not causing any discomfort and be very gentle. If it hurts we are reinforcing a fear that having their mouth cleaned is going to be painful

• If, despite our best efforts to be gentle, they find it too painful, we need to arrange for a dentist to see them as they could have an infection

How can we provide oral care for residents with dentures?

• Remove dentures and clean with a denture brush, or toothbrush kept for this purpose only

• Soak the dentures in a commercial denture cleaner, carefully following the manufacturer’s instructions

• The person’s mouth should be cleaned with toothpaste if they have teeth and a dry mouth gel may be used if they don’t have their own teeth

What if someone is refusing to brush their own teeth or have anyone else do it for them?

An oral care educator who worked for the NHS used the following approach with very successful results:

“When providing oral health care for a anyone who often refuses it, I go armed with a new ultra-soft brush.

Then I tell them that I am giving out free toothbrushes and ask whether I can see the one they use now.I demonstrate the difference between their usual brush and the very soft one, usually on the back of their hands.

The next step is to ask them to smell the Buddies toothpaste I have with me and whether they’d like to taste it. If they do, they usually love the taste of it and then they allow me to brush their teeth using that and the soft brush.

I find I can often clean their mouth then rinse and dry the brush several times, continuing like this until the mouth is clean.”

What can cause a dry mouth?

• Dehydration medication (over 500 medications cause a dry mouth), including 80 antipsychotic medications for dementia, morphine and even oxygen

• Medical conditions including Parkinsons, diabetes, problems with the saliva glands, chemotherapy, radiotherapy, and many others

• Breathing through the mouth instead of the nose

• Note: People with a dry mouth may have thick, stringy saliva, cracked lips and a sore mouth. This will mean they are much more prone to fungal infections.such as thrush

What Can We Do to Relieve the Symptoms of a Dry Mouth?

Dry mouth is a common yet challenging condition that can complicate oral care. Here are some effective strategies for relief:

• Encourage sipping water frequently. Consider using products like dry mouth gels, sprays, or mouth rinses to keep the mouth moist.

• Choose a non-foaming toothpaste without sodium lauryl sulphate (SLS). This ingredient commonly aggravates dry mouth symptoms.

• Use a very soft toothbrush to avoid causing pain while still providing effective cleaning. A softer brush often works just as well for maintaining hygiene.

• Be aware that individuals with dementia may have changing tastes. Offering flavours different from their past preferences can enhance their experience. For instance, dental gels like Buddies toothpaste can cater to these evolving tastes while effectively adhering to toothbrush bristles.

  
  

What Changes or Abnormalities are Red Flags When Carrying Out Oral Care?

As a carer, it's essential to be aware of red flags during oral care. Here are critical changes to monitor:

• Physical Signs: Look out for lumps, ulcers, sore mouths, dry mouth, bad breath, bleeding, rashes, white patches, and loose or broken teeth. Each of these symptoms warrants immediate attention.

• Behavioral Changes: A sudden reluctance to wear dentures may signify discomfort or sore spots, which requires prompt intervention.

  
  

Recognizing these signs early can prevent more severe health conditions that require professional attention.

What Should We Do If We Notice Any of These Changes?

If you identify any of the warning signs mentioned, it is crucial to act swiftly. Schedule an appointment with a dentist or doctor as soon as possible to address potential issues before they escalate. For example, if a person has persistent bad breath, it could be indicative of gum disease that might worsen without timely treatment.

Prompt intervention ensures individuals remain comfortable and healthy, significantly enhancing their quality of life.

Important Takeaway for Carers

Providing effective oral healthcare is a vital responsibility for carers. It enhances the comfort and quality of life for those in care while preventing more significant health issues that can arise from neglect. By recognising the importance of oral health, understanding the challenges in providing care, and being vigilant in spotting warning signs, carers can truly impact the lives of those they support.

Compassionate and patient-centered care is invaluable in achieving effective oral health management.

Final oral care advice for members of staff in residential care facilities

It is essential to record the oral care provided in a residential home, so that other members of staff, including senior management, are aware of the current situation.

If a resident is constantly refusing all healthcare, this situation cannot be ignored. If a serious problem develops such as oral cancer; a requirement for multiple extractions or health being compromised due to mouth problems, evidence of due care and attention will be required.

Best practice is for there to be an oral healthcare champion within any care or nursing home and a bespoke oral care plan should be available for every resident.