Toothbrushing for people with reduced dexterity

The ease of picking up a toothbrush to clean our teeth is a simple twice-daily act most of us are fortunate enough to take for granted. For some people, however, it’s difficult to manage toothbrushing because of their reduced dexterity.

As a result, people who cannot manage their oral hygiene routines themselves need assistance. Carers can help with oral care at home and organise invaluable professional help from a local dentist. Here are some tips I learned from looking after my mum that may help you to help someone you care for keep a comfortable mouth.

My mother has always taken good care of her teeth. She was diligent about brushing them twice everyday and flossing too. Being of her generation, with a husband who loved sweet things and also worked for a well known chocolate manufacturer, she had her fair share of fillings. And, when the teeth around her old fillings broke, crowns.

Now in her late eighties, her teeth are still basically her own. As I’m in the bathroom wielding the electric toothbrush, I do wonder whether it wouldn’t be easier to care for her teeth if I could take them out.

•  Information about gum disease
•  How to use an electric toothbrush

I have to thank mum’s dental hygienist

Without the advice of the dental hygienist, my mother would never have let me help her clean her teeth.

A visit to the dentist showed that mum wasn’t managing her own oral hygiene any longer. She needed two fillings and an extraction.

On a later visit, the hygienist pointed out to my mother areas of gum disease because of plaque build up in areas she wasn’t reaching with her manual toothbrush. She recommended an electric toothbrush. She also told my mother that I would need to help her to brush if she wanted to improve her gum health. I immediately bought a brush from the practice and, as soon as we got home, I set to work.

Of course, there was some resistance, but I did my best to be calm and reassuring. My mother asked a few times why I was cleaning her teeth when she’d managed to do it perfectly well for over  eighty-five years. I acknowledged her experience, reminded her of the hygienist’s advice, showed her how the new toothbrush worked and then we got on with it!

Brushing someone else’s teeth isn’t easy!

Although mum’s bathroom is a tight fit for two people, I can squeeze in to stand on her right. That’s good, as I’m right-handed. It also means that she can look in the mirror above the basin, which I think allows her to feel more in control. After all, she’s been looking in a mirror while she cleans her teeth all of her life.

We began with a head on the electric brush designed for a sensitive mouth. The hygienist said it would be better as her gums could become irritated by a stronger action. I did get hit by a bit of toothpaste splatter, but I quickly got the hang of smearing a bit of paste on the quadrant I wanted to work on, before turning on the brush.

Working around each quadrant of her mouth, I made sure I did the front, the inside and the top planes of all her teeth. I asked her to “Open wide!” and was even able to get the narrow head into the very back to brush the open edge of her final back teeth. I made sure I angled the brush against the margin where the gum meets the tooth to brush away bacteria from their favourite spot.

As the electric toothbrush does all the movement for me, it’s so much easier, and more effective, than trying to use a manual brush.  The model I bought has a built in pressure sensor which reassures me that I’m not being too rough. All I really have to do is lift the brush from one tooth to the next.

I also told my mother to spit, “Don’t rinse!” Mum had learned to rinse as well as spit out every last drop of toothpaste after brushing. She had taught us to do the same too. Now, with fluoride toothpastes, we should all skip rinsing, and just spit. Mum liked that bit! With just a quick wipe around her mouth, she was smiling and ready for some lipstick.

My tips for brushing another person’s teeth

• Allow plenty of time. It’s a good opportunity for some close contact and (one-sided) chat.
• Work out the best way to position yourselves for access to a basin and mirror.
• Use an electric toothbrush.
• Don’t rinse, just spit, to keep fluoride on the teeth.
• Book regular appointments with the dentist and hygienist.

Dental care for everyone is essential

For anyone with reduced dexterity, toothbrushing assistance is such a kindness. Whether it’s children under the age of seven, a teenager with a broken arm, or any person who has difficulty mastering tasks that require fine motor skills, a helping hand with an electric brush can make an enormous difference to their oral health.

Conditions that may compromise dexterity due to muscle wastage, reduced mobility, or cognitive difficulties include, but are not limited to:

• Arthritis
• Cardiovascular problems affecting blood flow
• Cerebral palsy
• Chronic fatigue syndrome (myalgic encephalomyelitis – ME)
• Dementia (eg Alzheimer’s, Creutzfeldt-Jakob, Huntingdon’s, Lewy body, Parkinson’s, vascular)
• Down’s syndrome
• Mental health concerns
• Multiple sclerosis
• Nerve damage
• Spina bifida
• Stroke
• Trauma, which may affect dexterity temporarily or long-term
• Upper-limb, neck or back problems, including repetitive strain injury

Looking forward

I am hoping, too, that by taking mum to the dentist regularly now for preventive care, it should save the cost of more expensive interventions later on. I hope so. As she heads into her nineties, I imagine accessing care will become more difficult. Therefore I’m determined to try to keep up a good oral health routine at home. I’m glad my mum still has her own teeth, because she’s proud of them. They may look well used, they are, but they work for her. I hope I can help her to keep them pain-free and as healthy as possible for as long as possible.

On the topic:

• Caring for older teeth
• Find solutions if you have dentures that are rubbing, slipping or clicking
• External link to dental care advice from Age UK

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