Easy dental care for all abilities

Dentist and dad of girl with Down syndrome gives these tips:

Family dental practitioner Andrew Pickens, DDS, of Pickens Family Dental Care in Billings, Mont., has practiced dentistry for more than 33 years. As a parent of a daughter with Down syndrome and caregiver for people with developmental disabilities, Pickens is no stranger to treating dental patients with a variety of abilities. He offers these dental tips to help find the right care.

“Being comfortable with people of all abilities and volunteering at Special Olympics and Special K Ranch have really helped,” he said.

Pickens says dental care for people with developmental disabilities often creates challenges for both the patient and the dental team.

“I have found that using my imagination and a caring patient approach have helped overcome many challenges,” Pickens said.

What to look for

Finding a dentist willing to provide care can be a difficult task. To take the stress out of going to the dentist, Pickens suggests looking for someone who regularly treats people with developmental disabilities.

“Many dentists seek special training through the dental association or schools to learn about treating people with developmental disabilities,” he said.

To help patients achieve and maintain oral health, Pickens recommends searching for a dentist willing to:
• provide care as well as scheduling and transportation,
• provide regular yearly exams and dental cleanings and
• educate on diet, which promotes good dental health and proper daily oral hygiene.

But most important, he says, is for patients to find an office setting they feel comfortable in to receive treatment.

“We find most people can have a comfortable, enjoyable visit for all procedures by the use of open, caring communication,” Pickens said.

Pickens’ office offers a full range of dental procedures from preventive care to crowns, bridges and dentures.

“If fear or anxiety are a problem, we use appropriate medications to reduce these,” he said.

Patients are referred to specialists when the office is unable to provide care such as complicated surgeries or braces, often at a significantly reduced fee.

Medicaid, dental care

Keep in mind that finding a dentist who treats patients with Medicaid benefits is especially difficult because many do not accept Medicaid or accept a limited number of patients, Pickens said. This is because payment by Medicaid covers only about 40 percent to 50 percent of the true cost of dental care, which is less than the cost of paying team members and supplies.

However, to Pickens and his staff, the benefit of treating people with disabilities is not monetary payment.

“Less tangible but more important rewards accrue to the dentist and team who learn how to successfully provide care for people with developmental disabilities,” he said.

Pickens said he and his staff are gratified by the appreciation shown by patients and caretakers, patients’ improved oral health and comfort, the ability to give back to the community and spiritual rewards.

Follow these ADA guidelines on brushing and flossing to achieve oral wellness:

  • Brush your teeth twice a day with an ADA-accepted fluoride toothpaste. Replace your toothbrush every three or four months, or sooner if the bristles are frayed. A worn toothbrush won’t do a good job of cleaning your teeth.
  • Clean between teeth daily with floss or an interdental cleaner. Tooth decay-causing bacteria still linger between teeth where toothbrush bristles can’t reach. This helps remove the sticky film on teeth called plaque and food particles from between the teeth and under the gum line.
  • Eat a balanced diet and limit between-meal snacks.
  • Visit your dentist regularly for cleaning and oral exams.

Antimicrobial mouth rinses and toothpastes reduce the bacterial count and stop bacterial activity in dental plaque, which can cause gingivitis, an early, reversible form of periodontal (gum) disease.

ADA-accepted antimicrobial mouth rinses and toothpastes have substantiated these claims by demonstrating significant reductions in plaque and gingivitis.

Fluoride mouth rinses help reduce and prevent tooth decay. Clinical studies have demonstrated that use of a fluoride mouth rinse and fluoride toothpaste provides extra protection against tooth decay over that provided by fluoride toothpaste alone. Fluoride mouth rinse is not recommended for children age six or younger. They may swallow the rinse.

Always check the manufacturer’s label for precautions and age recommendations, and talk with your dentist about the use of fluoride mouth rinse.

  • The ADA seal on a product is assurance that it has met ADA criteria for safety and effectiveness. Look for the ADA seal on fluoride toothpaste, toothbrushes, floss, interdental cleaners, oral irrigators, mouth rinses and other products.

What is plaque?

Plaque is a sticky film of bacteria that forms on teeth and gums. Following a meal or snack, the bacteria in plaque release acids that attack tooth enamel. Repeated attacks can cause the enamel to weaken, eventually causing tooth decay. Many of the foods we eat cause plaque bacteria to produce acids. If you snack often, you could be having acid attacks all day long. Plaque that is not removed with thorough daily brushing and cleaning between teeth can eventually harden into calculus or tartar.

Plaque also produces substances that irritate the gums, making them red, tender or prone to bleeding. After a while, gums may pull away from the teeth. Pockets form and fill with more bacteria and pus. If the gums are not treated, the bone around the teeth can be destroyed. The teeth may become loose or have to be removed. In fact, periodontal (gum) disease is a main cause of tooth loss in adults.

One way to prevent tooth decay and periodontal (gum) disease is by eating a balanced diet and limiting the number of between meal snacks. If you need a snack, choose nutritious foods such as raw vegetables, plain yogurt, cheese or a piece of fruit.

What are some tips for daily oral care?

The best way to remove decay-causing plaque is by brushing and cleaning between your teeth every day. Brushing removes plaque from the tooth surfaces.

  • Brush your teeth twice a day, with a soft-bristled brush. The size and shape of your brush should fit your mouth, allowing you to reach all areas easily.
  • Use a toothpaste that contains fluoride, which helps protect your teeth from decay. When choosing a dental product, look for the American Dental Association Seal of Acceptance, an important symbol of a dental product’s safety and effectiveness.
  • Cleaning between the teeth once a day with floss or interdental cleaners removes plaque from between the teeth, areas where the toothbrush can’t reach. It’s essential in preventing gum disease.
  • By taking care of your teeth, eating a balanced diet and visiting your dentist regularly, you can have healthy teeth and an attractive smile your entire life. Follow these tips to keep your teeth and mouth clean.

How do I brush?

  • Proper tooth brushing technique. Place toothbrush at a 45-degree angle against the gums.
  • Move the brush back and forth gently in short (tooth-wide) strokes.
  • Brush the outer tooth surfaces, the inner tooth surfaces, and the chewing surfaces of the teeth.
  • Use the “toe” of the brush to clean the inside surfaces of the front teeth, using a gentle up and down stroke.
  • Brush your tongue to remove bacteria and freshen your breath.

How to brush your teeth

How do I floss?

    • Break off about 18 inches of floss and wind most of it around one of your middle fingers. Wind the remaining floss around the same finger of the opposite hand. This finger will take up the floss as it becomes dirty. Hold the floss tightly between your thumbs and forefingers.
    • Guide the floss between your teeth using a gentle rubbing motion. Never snap the floss into the gums.
    • When the floss reaches the gum line, curve it into a C shape against one tooth. Gently slide it into the space between the gum and the tooth.
    • Hold the floss tightly against the tooth. Gently rub the side of the tooth, moving the floss away from the gum with up and down motions.
    • Repeat this method on the rest of your teeth.
    • Don’t forget the back side of your last tooth.

People who have difficulty handling dental floss may prefer to use another kind of interdental cleaner. These aids include special brushes, picks or sticks. If you use interdental cleaners, ask your dentist about how to use them properly, to avoid injuring your gums.
Brushing and flossing guidelines reprinted with permission by the American Dental Association. 

5 steps to flossing

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