Medical conditions that affect oral health

Swallowing difficulties

Good oral care is very important when a child or young person has swallowing difficulties. Difficulty in swallowing may cause a dry mouth, increased drooling, food collecting in the mouth or acid reflux.

It is important to brush your child’s teeth twice a day with a non-foaming fluoride toothpaste recommended by your dentist.

• When cleaning the mouth of someone with swallowing difficulties, extra care should be taken to reduce the risk of inhaling toothpaste or any debris that may be present in the mouth.
• If food collects in the mouth, the carer should encourage rinsing the mouth with water.
• If your child suffers from acid reflux, do not brush immediately after the reflux. Instead, they can rinse their mouth with some water.

Ask a health professional for further advice.

Tube-fed patients

Children and young people who are tube fed are more likely to build-up tartar (calculus) and this can be difficult to remove safely, especially where there is an unsafe swallow.

Daily mouth cleaning is very important because plaque bacteria can cause chest infections.

Toothbrushing twice a day will help to avoid these problems and keep the mouth fresh, gums healthy and prevent tartar build-up.

• Try to gently brush the tongue to prevent it becoming coated.
• Follow the toothbrushing guidance in the toothbrushing leaflet.
• To prevent inhalation, gently tilt the head forward. Do not wet the toothbrush before brushing and push the toothpaste into the toothbrush bristles.
• Suction is not normally needed if careful head positioning is used. However, if you have an oral suction at home you may wish to use it.
• A non-foaming toothpaste can be helpful as they do not contain sodium lauryl sulphate which is a foaming agent.

Dry mouth advice

• A dry mouth can be a side effect of some medicines and medical conditions.
• Children and young people with a dry mouth are more prone to tooth decay, gum disease and mouth infections.
• Having a dry mouth is very uncomfortable so encourage taking sips of water often.

Ask your dentist for advice on products that can be used.

For more information email: dentalservice@bdct.nhs.uk