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Managing dental emergencies in community pharmacy: hard tissue conditions


People of all ages with intellectual(ID) or learning disabilities may have difficulty describing and communicating dry mouth and practising good oral and dental hygiene. Data indicate that people who have ID have more untreated dental 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, and refusal to eat or swallow food whole. This can have an impact on the mental and physical health of a person with an ID. People with ID may have a mental health illness and may be prescribed multiple psychotropic and other medications. Dry mouth associated with many medications and some physical conditions can affect dental and oral health. Saliva helps to neutralise the acid that attacks teeth and is an important part of dental health. Saliva helps to break down food while chewing, allowing the person to swallow more easily. Some people find that they have problems with swallowing when their saliva flow is affected. Many people with ID may have other conditions such as cerebral palsy, seizure or psychiatric disorders, attention deficit/hyperactivity disorder, or problems with vision, communication, and eating. These may all be associated with difficulties with oral and dental hygiene. Though language and communication problems are common in anyone with ID, motor skills are typically more affected when a person has coexisting conditions. Managing tooth cleaning, holding a toothbrush or dental floss, rinsing mouth etc. may all be difficulties for people with ID and/or their carers. Multi disciplinary input is important and should include pharmacy, dietician , speech therapy and occupational therapy. It is important to ensure good quality oral care in this vulnerable population group. A good information source is: Practical Oral Care for People With Intellectual Disability National Institutes of Health, National Institute of Dental and Craniofacial Research (NIDCR). NIH Publication No. 09-5194 Some information from this document : PERIODONTAL DISEASE. Medications, malocclusion, multiple disabilities, and poor oral hygiene combine to increase the risk of periodontal disease in people with ID. Encourage independence in daily oral hygiene. Ask patients to show you how they brush, and follow up with specific recommendations on brushing methods or toothbrush adaptations. Involve your patients in hands-on demonstrations of brushing and flossing. Some patients with ID cannot brush and floss independently due to impaired physical coordination or cognitive skills. Pharmacists should talk to their caregivers about daily oral hygiene. Do not assume that all caregivers know the basics; demonstrate proper brushing and flossing techniques. A power toothbrush or a floss holder can simplify oral care. Pharmacists should emphasize that a consistent approach to oral hygiene is important–caregivers should try to use the same location, timing, and positioning.

Posted date

8 MAY 2019

Posted time



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