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Readers' comments (1)

  • Comment on : Older adults at risk of medication-related dry mouth
    Dry mouth may be a problem in the ageing general population. It can however be a lifetime difficulty in the population with intellectual/learning disabilities.
    In general, all people with intellectual/learning disabilities have poorer oral health and oral hygiene than those without this condition. When a person develops a dry mouth ( whatever the cause) they may experience saliva that has become thick and sticky, making it difficult to speak or swallow. They may also have a ‘prickly' or burning sensation in their mouth and become sensitive to certain foods. With a dry mouth, the mouth can become sore and there is a higher risk of tooth decay and gum disease. People of all ages with intellectual/learning disabilities may have difficulties describing and communicating dry mouth and also practising good oral and dental hygiene. Data indicate that people who have intellectual disabilities have more untreated caries and a higher prevalence of gingivitis and other periodontal diseases than the general population. Periodontal disease gives rise to periods of acute infection and pain, which may result in changes in behaviour, refusal to eat or swallowing food whole. This can have an impact on the mental and physical health of a person with an intellectual disability of any age .
    Dry mouth associated with medications and some physical conditions can affect dental and oral health. Saliva helps to cancel out the acid that attacks your teeth, and is a very important part of dental health. Saliva helps to break down food while the person is chewing, allowing the person to swallow more easily. Some people find that they have problems with swallowing when their saliva flow is affected. Saliva is also very important in fighting tooth decay. It helps to fight the bacteria that form dental plaque and cause tooth decay and gum disease. Having less saliva can also affect the taste of food and makes it harder to eat drier foods. This can have an impact on nutritional status, body mass index and physical health. Dry mouth can also affect speech in people with intellectual disabilities who may already have communication difficulties . It can also make people with intellectual/learning disabilities of any age more likely to have bad breath and have an impact on their participation in their social environment.
    Each person, young and old, with an intellectual/learning disability should have a written or individual person centred oral and dental care/wellness plan . Oral/dental care plans should include a record of professional care to be provided by each professional and the daily oral care to be provided in the person’s home environment. Oral/dental care plans should be part of Health Care /Wellness plans. Multidisciplinary input will be required from pharmacists(in relation to medications), dieticians ( in relation to nutrition), occupational therapists ( in relation to dexterity and ability to use toothbrush etc.), speech and language therapist ( in relation to feeding, eating, drinking and swallowing ability etc. ) and others.
    What to do for Dry Mouth:
    • Saliva replacements may be useful.
    • The use of sugar-free chewing gum (if appropriate) and sugar- free fluids ( including sugar free oral liquid medication) should be advised.
    • The mouth should be examined frequently.
    • Fluoride rinses should be considered to reduce risk of dental caries.
    • An opinion should be sought from an appropriate dental specialist if required.
    • Medication review if medications are implicated in dry mouth.

    Prepared by : Bernadette Flood PhD, MPSI Dec 18th 2017

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