There is not one right way or one wrong way to provide dental care to people with disabilities. Sometimes it requires patience and skill, and sometimes it requires no assistance at all! Usually, it’s somewhere between. Whatever the circumstance may be, we always find success when we focus on dignity, respect, and compassion.
It is important to stress that this is a generalized guide to dental care. If you want specific advice, please schedule a consultation and we will be happy to provide you or your client a personalized dental care plan. Having a healthy mouth affects the entire body, so we want to make sure you have as much guidance as possible.
As a caregiver, you know as well as anyone else how challenging it can be to help some individuals with dental care. Although the needs of each person vary, we have some basic tips that work for many people.
One of the most common roadblocks is UNCERTAINTY. Being caught off guard is startling for anyone. Helping your client feel prepared makes all the difference in the world.
TELL-SHOW-DO
Our most reliable and most commonly used approach to manage uncertainty is the Tell-Show-Do method.
TELL your client about each step before you do it. For example, explain how you’ll help them brush, and what it feels like. This removes the element of surprise and allows time to prepare mentally and physically as best they can. SHOW how you’re going to do each step before you do it. It helps to let your client hold and feel the toothbrush, any water, or floss if they are able. If they are unable to grasp a toothbrush, rubbing the brush along their hand, arm, or cheek prepares them for the sensation. This increases familiarity and comfort levels. DO the steps in the way you’ve explained them. We use this same method during regular treatment. Analogies, visual aids, and a lot of patience go a long way.
Have a ROUTINE. Use the same technique at the same time and place every day. Many people with developmental disabilities accept dental care when it’s familiar. A routine soothes fears and eliminates uncertainty. Ideally, brushing and flossing occurs morning and night, but if there is a specific time of day your client tolerates care better, don’t hesitate! Any brushing is better than no brushing at all.
Be CREATIVE. Distractions go a long way. Let your client hold a favourite toy, or a special comfort item. Others make it a game, or play a familiar song. One of our most successful techniques is simply counting to ten, then allowing for a break. You can count quickly, or slowly, depending on how well your client is tolerating the oral care. Here are some creative ways to alter toothbrush handles. We are always open to suggestions as well so when you are at the office, let us know what works best for you and your client.
Positioning: Where to Sit or Stand
Keeping everyone safe when you clean their mouth is important. We recommend standing or sitting behind your client rather than in front. Use your arm to hold their head gently against your body. That gives you access to their mouth, similarly to the way we do here in the dental office. If the person you are helping is in a wheelchair, be sure to lock the wheels, then tilt the chair into your lap. Remember to always get permission from your client, and do your best to avoid startling them. Let them participate as much as possible.
Trust!
It may take time for the person you care for to become comfortable having their oral care taken care of, both in and outside the office. We often do a “get acquainted” visit with no treatment provided. These visits go a long way toward building relationships, comfort, and trust. Keep that in mind while developing an oral care routine with your client. If you are able, ask your client how to best help them. Oral care can be a personal thing, so remember to include them as much as possible.
Oral care can make a big difference in the quality of life for everyone. Those with disabilities can be high-risk for gum disease, cavities, and other oral diseases. What you do regularly goes a long way toward making dental visits easier. Together, we can keep your client or loved one free from pain and infection.
Acknowledgements:
National Institute of Dental and Craniofacial Research, National Institute of Health, U.S. Department of Health and Human Services
Photography: Matthias Zomer, Mikhail Nilov, Cliff Booth, Rodnae Productions, Pexels
