Encouraging and supporting people that we care for to maintain their oral health is important for their general health and overall quality of life.

In collaboration with NSW Health, this article will help you to support people who need a flexible approach to their daily oral care.

The following items can assist with toothbrushing.

If there are specific needs, please discuss them with your dental professional.

1. Soft bristled toothbrush: choose a brush with a small head, or an electric, or three-sided toothbrush
2. Fluoride toothpaste: sometimes higher strength fluoride, low foaming or chlorhexidine products may be recommended by your dental professional
3. Good light: find a well-lit area or use a head torch
4. Disposable gloves
5. Bowl or cup: if it is not possible to spit into a bathroom sink, try using a bowl or cup
6. Towel: use a clean bath towel to protect clothes and wipe the mouth
7. Mouth prop: if it is difficult to keep the mouth open, a soft clean damp face washer can be used to bite onto while brushing
8. Second toothbrush: a modified toothbrush can help retract the cheek and give better access to the mouth.

• Choose a time when you and they are relaxed and able to focus on the task.
• Ensure they are comfortable, well supported and upright as possible. When our heads are tilted back, we are more prone to gagging. If they are unable to sit up, try to support their head as best as possible with pillows and tilt their head to the side.
• Whether you stand in front of them or behind may differ depending on how well you can see the teeth and their personal preference.
• Ensure the person in your care understands what you are going to do and agrees to each step.
• Talk clearly and be calm, caring and patient in your approach.
• Don’t force it. It’s okay to take breaks or try again later.
• Aim to reduce plaque bacteria in the mouth everyday with brushing. Anything you can achieve will help them. Keep trying.

Aim to brush teeth and gums twice a day, but if this is not possible, brush at night with no eating afterwards.

If gums are bleeding it usually means they need to be brushed more, not less. Regular brushing with a soft toothbrush will help reduce or stop the bleeding. If it continues, consult a dental professional.

Dental floss, interdental brushes or flossettes can be used to clean between the teeth where a toothbrush can’t reach.

Additional care is needed for people with swallowing problems (dysphagia), dry mouth, sensitive gagging, and people not fed by mouth.

In these cases, you should:

• Remove food debris in the mouth prior to brushing.
• Use low foaming (SLS free) and low flavour toothpastes if preferred.
• Talk to a health professional and/or pharmacist about medications that cause dry mouth and products that provide dry mouth relief.
• Try a sprinkle of salt on the tongue to reduce gag reflex.

Even if a person is tube fed, cleaning their mouth every day is important.

Talk to your dental professional for further advice.

Maintain regular dental visits. If you notice any changes or have concerns when brushing someone’s teeth, contact their local dental clinic.