Disabilities and Oral Health

March is Disability Awareness Month.

At Lake Baldwin Dental, we’re committed to helping everyone who visits our dental office in Orlando, FL have great experiences and enjoy better quality of life through better oral health.

Many disabilities make it challenging to maintain good oral health. If you or a loved one are struggling with disabilities that create oral care challenges, we have a few suggestions that may help.

More importantly, we’re always here for you! We’re equipped and prepared to help patients with disabilities have great dental care experiences and are always happy to help you come up with strategies that will work for you.

disability awareness month
March is Disability Awareness Month!

Disabilities That Affect the Hands and Arms

Brushing and flossing properly can be difficult for even the most dexterous person.

There are many disabilities that can make it hard to move the hands and arms, which can make it difficult or impossible to use good technique when brushing and flossing.

  • Arthritis can limit movement in the fingers, wrists, elbows, and shoulders. Arthritis in the hands can make it hard to pinch or grasp with enough force to use a manual toothbrush or floss.
  • Parkinson’s disease affects control of the muscles, and frequently starts in the hands. It can cause slow movement, tremors, stiffness, and muscle weakness.
  • Limb differences include the loss or disfigurement of fingers or appendages, or congenital differences that a person is born with.
  • Temporary disabilities include injuries like a broken arm or wrist, or chronic problems like carpal tunnel syndrome that come and go.

How to Work Around It

arthritis flossing brushing
Brushing and flossing with arthritis is difficult.

There are tons of gadgets out there that make it easier for people with dexterity problems to enjoy great oral health.

First, an electric toothbrush will make it much easier to brush effectively.

We recommend the Phillips Sonicare. Its powerful vibrations disrupt plaque biofilm on the teeth and even under the gums without the need to scrub. It has a wide handle, which is also easier to grip.

Second, a water flosser can clean between the teeth and in hard-to-reach places without the need for string floss.

We like the WaterPik. Like the Sonicare, it has a wide handle and it’s very easy to use. Flossing the old-fashioned way takes a lot of dexterity and hand strength. With a WaterPik, you can just drag the tip gently over the gumline and let the water do the work!

There are tons of other instruments out there if you don’t want to go the high-tech route.

If you’re struggling with your home care, always feel free to ask our team for ideas to make things easier!

Disabilities That Make It Hard to Control the Mouth and Throat

Some disabilities make it difficult to open and close the jaw, control the lips or tongue, or control swallowing.

Problems with swallowing can be especially dangerous, since choking becomes a lot more likely. It also becomes much more likely that a person will inhale liquid and develop pneumonia. So rinsing with water or keeping toothpaste out of the throat can be huge hurtles to good hygiene.

These types of disabilities include:

  • Progressive neurological issues like Alzheimer’s and dementia, Parkinson’s disease, ALS, and MS can all affect control over the muscles of the face and neck, including swallowing, especially in their late stages.
  • Injuries to the nervous system including stroke, spinal cord injuries, seizures, and cerebral palsy can affect the muscles of the face and neck.
  • Intellectual disabilities can may lead to an overactive tongue or lips, or inability to tolerate oral care. Patients with Down syndrome frequently struggle with an oversized tongue and difficulty controlling swallowing.
  • Problems with the jaw joints can make it hard to open wide enough to brush or floss effectively, or to get effective dental treatments. These problems include arthritis in the jaw joints, injuries like a broken jaw, and damage to the cartilage or muscles around the jaws.

How to Work Around It

Alzheimer's oral health
Many progressive neurological issues affect swallowing in their later stages.

If you’re caring for someone who can’t care for their teeth on their own, you’ll need to be sure their teeth are thoroughly cleaned daily.

People with neurological difficulties often experience serious health issues that stem from poor oral health. Overgrown bacteria in the mouth can increase risks for life-threatening infections and pneumonia, so it’s essential to do what you can to keep their teeth and tongue as clean as possible.

If you’re caring for someone who can’t control their opening and closing muscles, it can help to create a prop for them to bite on and keep their mouth open while you work.

This can be something simple like a toothbrush handle with a cloth wrapped around it. Whenever possible, keep your fingers clear of the biting surfaces, as even accidental bites can become serious medical emergencies.

Patients who have problems controlling swallowing may be limited to thickened liquids, such as water with thickening agents. These can be used to rinse the mouth just like normal water.

Or, if rinsing isn’t possible, a soft cloth can be used to sweep out the cheeks and wipe the surface of the tongue and roof of the mouth. Strictly speaking, it’s not necessary to rinse out after brushing as long as you can get most of the foam out.

If you have limited range of motion in your jaw, an electric toothbrush and water flosser can be incredibly helpful. Be sure to take lots of breaks as needed. You can also use a warm compress and gentle massage to help relax tight muscles.

Mental Health Disabilities and Sensory Difficulties

Other than physical limitations, there are many mental health and sensory input disorders that can make oral care incredibly challenging.

  • Depression and associated mental health conditions can make it impossible to find the motivation for many self-care tasks. We’ve found that taking care of the teeth is commonly one of the first routines people lose as they struggle with depression or similar disabilities.
  • Cognitive decline like Alzheimer’s and dementia can make it difficult to remember regular routines like tooth brushing. As these conditions progress, people may become resistant to allowing others to help care for their teeth and become agitated when it’s time to have their teeth cleaned at home or in a clinical setting.
  • ADHD makes it very difficult to maintain habits. Children with ADHD may be very resistant to tooth brushing.
  • Autism and sensory input disorders frequently make oral care incredibly overwhelming. The physical sensation of a toothbrush or floss may trigger gagging, and flavors in toothpaste and mouthwash can be difficult or impossible to tolerate.
  • Obsessive compulsive disorder, on the other hand, can lead to fixation on oral care that leads to overbrushing or flossing too much or too roughly, which can damage the teeth and gums.
  • Eating disorders can also harm the oral health in many ways, including nutritional deficiencies, burns from stomach acid, and injuries from tubes or other devices used to induce vomiting.

How to Work Around It

First and foremost, getting help from a qualified and compassionate mental health specialist is essential. Depending on the specific diagnosis and needs you or a loved one may have, there may be a wide range of options to help you enjoy good oral health.

For people who struggle to find motivation to care for their oral health, do what you can to make brushing and flossing more approachable for you.

That may mean using gadgets like an electric toothbrush or water flosser.

It may mean bringing floss to bed with you so you can do it without getting up. You may find it easier to brush in the car, outside, or even in a chair while you watch television.

The key is to do whatever you can. It’s better to do a bad job of it than no job at all. Take your wins where you can get them and give yourself credit for any attention you give your oral health.

If you’re a parent to a child with ADHD, autism, or other conditions that make them very resistant to tooth brushing, Sonicare comes with an app that gamifies brushing. Creating a reward system that’s motivating for neurodivergent children can sometimes make a huge difference.

autism brushing and flossing
Autism can make brushing and flossing feel overwhelming.

For sensory disorders, it may take a lot of trial and error, but look for mild toothpastes or flavors besides mint. Sensodyne toothpastes tend to have a very mild flavor that’s easier to tolerate for many people.

For people struggling with compulsions like OCD or eating disorders, you may need to work closely with a therapist to find ways to overcome obsessive thinking, rituals, or intrusive thoughts that create damaging habits. We’re here to help repair the damage and help you enjoy great oral health while you recover, completely free of judgement.

How our team can help

Dental visits can be uniquely overwhelming for people with disabilities and their caretakers.

At Lake Baldwin Dental, we’re proud to offer compassionate care to every patient, and will do everything we can to adapt to your specific needs.

Our practice is designed with roomy yet private operatories where we routinely accommodate large electric wheelchairs.

We have high volume evacuators to minimize the risk of choking while we use water, and frequently plan appointments with added staff to help with suctioning if needed.

If you or a loved one need thickened liquids, we can work with that as well, and have experience helping patients maintain their oral health using thickened water.

Our mission is to provide excellent oral healthcare in a completely judgement-free zone. Many patients come to us after prolonged struggles with disability, depression, or other issues that have lead to severe dental problems that left them feeling ashamed or anxious about their teeth.

If you’re overwhelmed or hesitant about seeking oral care for any reason, feel free to schedule a consultation to talk to us about it. We’re here for you.

Because everyone deserves a healthy smile!

disability awareness ribbons