Establishing good oral healthcare routines
As parents and carers we are charged with ensuring the wellbeing of those we care for. This includes bearing responsibility for teaching and maintaining behaviours which will provide personal health and comfort throughout their lives. As a parent and someone who studied dentistry for a while, I know that establishing a basic routine of brushing teeth with fluoride toothpaste for two minutes twice per day is a fundamental building block of a strong foundation for health.
The NHS simply explains the importance of regular brushing in this way: “Plaque is a film of bacteria that coats your teeth if you don’t brush them properly. It contributes to gum disease and tooth decay. Tooth brushing stops plaque building up”.
Challenges encountered in establishing a routine
That sounds fair enough doesn’t it? The reality though, as I know from personal experience, can be difficult and frustrating to practice. What if the person in your care just doesn’t want to play ball? My eldest son firmly resisted all our efforts to do this, resulting in a battle of wills twice per day every day. This was not the sort of routine I had in mind!
For others, brushing in itself may not be an issue, but the discipline of doing anything on a regular basis may be a problem in itself. As a carer, this can result in a real sense of failure and worry about the impact of impact of poor habits.
When I investigated this issue, there seemed to be some common barriers and some good tips, which I thought worth sharing:
1. Check whether there’s a specific issue
When it comes to brushing teeth, the vast majority see it as a necessary chore and accept it as something that just needs to be done. For some though, there may be an element of the process that makes it unpleasant for them. In which case, of course they will be reluctant to do it. If any such issue can be identified and solved, this may well remove the barrier.
Some of the most common problems are:
- Taste of toothpaste: A minority of people (but still a significant number) are particularly sensitive to certain flavours. Recent evidence suggests that mint actually tastes different to some. In this case, it is worth trying some alternative flavours. There are some available without fluoride, so bear in mind that dentists always advise using the appropriate level of fluoride for best protection from decay. Choosing a flavour the person in your care finds pleasurable to use, will make them much more likely to want to brush.
- Pain: There are a number of possible causes for this and it’s always worth checking with a dentist about any prolonged pain. If it’s generalised sensitivity in adults, then specialist toothpastes may help. Perhaps consider switching to a brush with softer bristles, as this can still provide effective cleaning.
- Electric brush too powerful: Some people struggle with the sensation of movement in their mouths. I’ve heard young children say that their electric toothbrush makes their head hurt. Many of the electric brushes on the market are very powerful and older adults and those with special needs may struggle too.In this case it’s worth finding a brush that best suits the person’s needs. There are brushes available with more gentle movement. Remember though that brushing with a manual toothbrush, ensuring each surface of every tooth is brushed, can be more effective that a quick whizz around with an electric one.
2. Give yourself the best chance of success
Plan to succeed. For example pick the best times to practice. Perhaps make it the first thing they do when they climb out of bed. Or after breakfast works well for many. Making it a regular time each day, perhaps linked to another action helps.
If there is due to be a disruption such as a holiday, decide and together how to fit the brushing routine in to your temporary schedule.
3. Prioritise the routine and schedule a reminder
Recognise that establishing this routine is important to you. Set up reminders in whatever way works best for the person you care for
4. Reward success
This is psychologically important in making a routine stick. It can take many forms and needs to be whatever resonates for the individual concerned. For a young child it may be a sticker chart. For an adult, perhaps a new toothbrush or other treat they will enjoy.
5. If the routine wavers
Despite our best efforts, setbacks are likely.
The main thing is to get back on track as soon as possible if things veer off course.
And don’t feel too bad. Research at University College London indicates that on average it takes 66 days for a routine to become a habit, depending on how difficult the routine is. Thus reinforcing that making brushing teeth as pleasant an experience as possible will ensure success.
Happy brushing and best of luck.
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