Clean the teeth
People with special needs should also learn toothbrushing techniques. However, they
need to be taught individually through a longer period of time with repetitive practices
in order to master the techniques. Parents and nurses need to assist them before
they can completely master the techniques in toothbrushing.
• First, let them face a mirror with you standing behind them. Using one hand
to support their chin, and the other hand to help them brush.
• If they can hold their own toothbrush, let them brush on their own. You need
to supervise, observe and correct their brushing technique.
Possible difficulties encountered when assisting people with special needs to clean
their teeth
Dental plaque forms on the surface of a denture. In
order to maintain the hygiene of the mouth and denture, the denture should be taken
out for cleaning every night.
If the person doesn't know how to spit, it is difficult for him to rinse after toothbrushing.
You can first let him wear an apron to avoid getting his clothes wet. Prepare a
glass of drinking water for him to rinse. When he needs to rinse, teach him to first
open his mouth and then slowly pour the water into his mouth. Let the water flow
out from his mouth so that the foam from toothpaste will be rinsed out from his
mouth naturally.
Swallowing toothpaste while brushing
Use only a pea-sized blob of toothpaste to brush his teeth. No harm will be done
to his body even if he accidentally swallows the toothpaste. Fluoride is effective
in preventing dental caries and strengthening teeth, therefore it is essential that
fluoride toothpaste is used. If you are worried that the fluoride content in toothpaste
is too high, you might consider using children's fluoride toothpaste which contains
only half of the fluoride content as the regular adult fluoride toothpaste.
Involuntary wobbling of the head
You may stand behind him, use one hand to wrap around his head, and gently support
his chin to stabilize his head. Remember to do this only if he is willing, otherwise
he will refuse to brush or floss his teeth.
Protruding tongue which interferes with toothbrushing
Tongue protrusion during toothbrushing is a natural reflex. You may first ask him
to calm down and start toothbrushing for him as soon as he relaxes his tongue. There
is only a short period of time while he relaxes his tongue. Therefore you may need
to precisely place the toothbrush inside his mouth and speed up the brushing process
to make toothbrushing more pleasant for him. You may also consider using an electric
toothbrush to shorten the time needed for brushing. However, you should use a correct
brushing technique with care in order to avoid damaging his teeth and gum.
Biting on toothbrush
You may use some supplementary tools (e.g. a few chopsticks wrapped by a towel)
for him to bite on one side of his mouth so that his mouth will stay opened. You
can then place the toothbrush inside his mouth and start brushing on the other side
of his mouth for him.
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Being impatient
You may start by brushing the easiest areas such as the outer surfaces. This can
be done even if he is closing his teeth together. Then ask him to open his mouth
so that you can brush the chewing surfaces and inner surfaces of his upper teeth.
Finally, you can brush the inner surfaces of his lower teeth.
Refuse toothbrushing
Find out the reason why he refuses to brush, then target at this reason to help
him overcome his hard feelings towards brushing. If toothbrushing brings him discomfort,
his gum may be sensitive due to gum inflammation. You may first choose a softer
toothbrush and let him try to get used to brushing only a few teeth. After he gets
used to brushing, you can then try to brush the rest of his teeth. Ask him to raise
his hand when he feels uncomfortable and stop brushing to let him take a rest. It
is important that you must not try to brush all his teeth by force. Otherwise, it
will be difficult to change his attitude toward toothbrushing in the future.
Gagging when he brushes his teeth
You may use a toothbrush with a smaller head. When you are brushing his molars,
try not to place the toothbrush too far back as long as you can brush his last tooth
in order to avoid gagging. If there are sensitive areas which make him gag, you
should brush those areas last.
Crooked teeth which are difficult to clean
You may use a toothbrush with a small head. Pay special attention to areas of irregularity
to make sure that the bristles have touched the gingival margins. This could ensure
that the teeth are thoroughly cleaned.
Difficulty in inserting the dental floss into the interproximal area (area between
the teeth)
Difficulty in inserting the dental floss into the interproximal area may be caused
by the accumulation of calculus. The situation will improve once the calculus has
been removed by the dentist. Remember to floss daily after the calculus has been
removed in order to avoid accumulation again.