Carers…

A guide to some of the common issues experienced
when providing oral care as a carer

Why oral care is important – Beating bacteria

When people are unable to manage their own oral care, they are reliant upon carers to implement effective dental hygiene routines for
them. Good oral health is critical to everyone’s overall well-being. The mouth is vital for eating, drinking, breathing and communication.

Poor oral health can lead to infections which left untreated can cause pain. Bacteria from gum disease can enter the bloodstream
causing blood poisoning and may also be related to other diseases such as heart disease, diabetes and pneumonia.

Taste

Smell

Touch

Sound

TASTE

People with sensory processing issues can be overly sensitive to certain tastes, from cooking spices to minty toothpastes.

People may develop sensitivities during their life, possibly due to chronic conditions such as dementia or medication. Carers may therefore find that someone suddenly rejects a toothpaste they’ve used for years as they now find the taste too strong.

In circumstances where someone refuses to accept oral care, it can be extremely difficult to provide it, causing frustration and worry for the carer and a downward spiral for oral care provision and overall health. Finding a toothpaste that tastes good can be the key to them accepting oral care

SMELL

People with sensory processing issues can be overly sensitive to certain smells, from minty toothpastes to scented shampoos. Taste and smell are closely connected. Your taste buds can identify basics such as salty, sweet, sour and bitter. But your sense of smell provides the rest of the input to notice flavour. That’s why smell can make a difference to people with taste sensitivities.

People may develop sensitivities during their life, possibly due to chronic conditions such as dementia or medication.

Carers may therefore find that someone suddenly rejects a toothpaste they’ve used for years as they now find the smell turns them off. In circumstances where someone refuses to accept oral care, it can be extremely difficult to provide it, causing frustration and worry for the carer. Finding a toothpaste that smells good can be the key to them accepting oral care

TOUCH

When providing oral care for others, its invasive nature may be a real problem for some. The size of brush head used can make a real difference as to whether a carer is able to persuade someone to allow a toothbrush in to their mouth. Then once in, it is easier to manoeuvre a small brush to clean effectively.

The texture of toothpaste used and the firmness of toothbrush bristles will also need to be considered.

A very firm toothpaste is likely to fall off the brush, limiting the effectiveness of the protective fluoride it contains. A low foaming toothpaste is easier for carers to use and probably means the paste won’t contain SLS (Sodium Lauryl Sulphate) which can cause dry mouth.

A manual toothbrush with compact soft to medium bristles is suitable for most people, but super soft bristles are kinder for those who:

  • Are frail or suffering from dementia and reject or refuse oral care
  • Have sensitive areas in their mouth due to gum disease or other infections
  • Are suffering from dry mouth
  • Have loose teeth
  • Have sensitive teeth
  • Where possible, making any oral care experience as pleasant as possible for a person is the best way to ensure they are happy to repeat it. As a carer, offering choice is key.

SOUND

The noises associated with provision of oral care can be particularly distressing for someone with aural sensitivity. Of course this is most often linked to the sound of the dentist’s drill, but even the noise of bristles brushing against teeth may be a source of discomfort and stress to some.

Most electric toothbrushes are noisy to use and it can be difficult to find one suitable for these situations.

Ageing and the elderly

Elderly people may have problems managing their own dental hygiene due to issues with dexterity. Long-term conditions such as arthritis and Parkinson’s disease can make it harder to hold and use a toothbrush and to go for dental treatment.

People now keep their natural teeth for longer, but this can mean they need more complex dental care than people without dentures. On the other hand, denture wearers are at increased risk of chronic denture stomatitis, a common condition where mild inflammation and redness of the oral mucous membrane occurs beneath a denture.

Dry mouth (xerostomia) is a common complaint found often among older adults, affecting approximately 20 percent of the elderly. However, xerostomia does not appear to be related to age itself as much as to the potential for elderly to be taking medications that cause xerostomia as a side effect.

Saliva has many important functions including antimicrobial activity, mechanical cleansing action, control of pH, removal of food debris, lubrication of the oral cavity and remineralisation.

Dementia and Alzheimer’s

People living with dementia have a high rate of tooth decay and gum disease possibly because they find it difficult to perform their daily activities. Others may not be able to express that they have a toothache and leave problems untreated.
It is common for people with dementia to lose their sense of taste, so they tend to like strong tasting food, especially sweet food and drink, even if they haven’t liked it in earlier life. It’s important that people living with dementia receive the help they need to keep their teeth and gums clean and free of debris so that they can maintain their self-esteem and avoid pain and infections

What’s in our toothpaste?

As a parent or guardian we often a worry about what our little ones put in their mouths, and toothpaste is no different. We encourage healthy brushing habits, brushing twice a day, yet when we look at the ingredients on our toothpastes we often don’t really know what we’re putting into our children’s mouths. So to put your minds at ease we’ve created a summary of our ingredients:

Cocamidopropyl Betaine (CAPB)

This acts as a detergent for our mouth, whilst also making the paste easier to spread around the mouth. In addition to this, it can help maintain the flavour of the toothpaste and relieve dry mouth. We have chosen CAPB over SLS (sodium lauryl sulphate) as SLS can have some unwanted side effects, especially to those with sensitive skin as it can cause irritation such as mouth ulcers and a rash around the mouth.

Cellulose Gum (CMC/Carboxymethlcellulose)

This is used to hold the toothpaste texture together and bind water. It is sometimes called a dietary fibre and is an additive that isn’t absorbed by the gut, meaning allergic reactions are extremely low. In large quantities it can act as a laxative, but within the quantities in toothpaste, this isn’t a worry.

Glycerin

This is a non-toxic odourless, colourless, viscous liquid. We included this ingredient to stop our toothpaste from drying out and maintain its consistency. It is slightly sweet tasting and again, keeps the paste smooth. Contrary to internet rumours, Glycerin is soluble in water and any left over traces would be quickly removed by saliva.

Sodium Fluoride

This additive is used to remineralise our teeth, strengthening the enamel in the process. With a lack of mineralisation comes discolouration and can cause white spots to appear on our teeth. The wrong amount of fluoride can be harmful to developing teeth and is why we shouldn’t swallow toothpaste. The NHS recommends no less than 1,000ppm of fluoride in children’s toothpaste. This equates to a pea sized amount for ages 3+ and a smear for ages below 3. Our toothpaste pumps relieve you of this stress as one press of the pump will dispense the exact amount for your child’s teeth.

CI 19140 (Tartrazine/E102) and CI 42090 (Brilliant Blue/E133)

These are used to colour our toothpaste. We have used the safest possible colourings with only 0.1% of the population being intolerant of our selected colourings. We have also made sure to include well below the safety limit maximum to further ensure safety.

Hydrated Silica

This is a naturally occurring ingredient that can also be manufactured from silicon dioxide. We include hydrated silica to provide a comprehensive clean and polish to the teeth which acts by exfoliating the biofilm on teeth (pre plaque).

Sorbitol

Used as a sweetener, but it also neutralises plaque whilst acting as a humectant which means it can trap water within the paste, keeping it a smooth texture. This ingredient only ever becomes harmful if large quantities of toothpaste is swallowed, for example eating over 50g per day would cause diarrhoea.

Sodium Chloride (Salt)

This is used as a natural exfoliant on biofilm on teeth.

Sodium Benzoate

This is a safe preservative used to prevent contamination by mould and other harmful bacteria. Due to the very small amount included in toothpastes, it is fine. However, in very large amounts, when mixed with vitamin C, it can form the carcinogen known as Benzene.

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