June 10th, 2025

Dental Care for Disabled People
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People with mild to severe disabilities depend partially or completely on their carers for their daily care.
 
It is a team effort between carers and dental professionals.
 
Healthy teeth and gums are important to people with disabilities
 
Sore or loose teeth make it hard to eat or sleep and they may not be able to tell you what is causing the problem.
 
Prevention of oral disease
 
Prevention of oral diseases (tooth decay and gum problems) for people with mild or severe disabilities is a challenging problem for carers and dental professionals.  Whenever possible, they should be encouraged and supported in their efforts to care for themselves.
 

Daily home care
 
a)         All people with disabilities
 
Diet:
 

• eat a well-balanced diet, high in fruit and vegetables
• consume minimal sugary foods and soft drinks (using straw) limited to meal times
• drink tap water after meals to rinse mouth and wash away food particles from teeth

 
Oral hygiene
 
Teeth:  Brush teeth with a manual or electric toothbrush twice a day – after breakfast and after dinner using a pea sized amount of a fluoride toothpaste and a soft toothbrush.
 
Lips, gums, tongue and palate (roof of mouth)  need  to be cleaned to keep healthy. Check with toothbrush, wipes or swabs to clear away food or medicines accumulated on gums, teeth or pouched (food held in the mouth and cheeks instead of swallowing)
 
Fluoride:  The fluoride in toothpaste and water strengthens tooth enamel, making teeth more resistant to decay.
 
b) People needing assistance from carers
 
Brushing other people’s teeth can be difficult, tips for carers include
 

• work in pairs, one carer supports the person’s head while the second carer brushes their teeth
• if it is difficult to keep the  mouth open, use three or four tongue depressors (or popsticks) taped together
• to create a better angle to clean the inner surfaces of the lower front teeth, modify the handle of a plastic toothbrush by placing it under hot water to soften the plastic and generally bend the brush handle
• if the person bites the toothbrush, use a second toothbrush to brush

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• for people who pouch food, inspect their mouth after each meal or dose of medicine and remove any remaining food or medicine from the mouth by sweeping the mouth with a finger wrapped in gauze or using a disposable swab.

 
For people who are less compliant and at higher risk of developing:
 

• tooth decay - high strength fluoride toothpaste, gels or rinses can be used on professional dental advice
• gum disease – apply chlorhexidine get on the teeth gum margins before bed.

 
If person gags or cannot rinse or spit, a smear of high fluoride concentration toothpaste can be used or pour fluoride rinse or chlorhexidine into a cup, dip the head of the toothbrush onto it and then brush the teeth.  Repeat dipping and brushing until finished.
 
c) People with partial or complete dentures
 
Clean dentures (false teeth) after each meal with soap using a toothbrush and leave them in water overnight.
 
d). People not fed by mouth
 
These people need to have their teeth, lips, gums, tongue and palate cleaned like everyone else.
 
Dental healthcare checklist
 
✅        Healthy diet
 
✅         Brush teeth twice daily with  FLUORIDE toothpaste and a soft brush.
 
✅         Look for early signs of gum disease
 
              - gums that bleed easily
              - persistent bad breath
              - trouble chewing
 
✅          Drink tap water after meals
 
✅           Look for any changes in the mouth or behaviour when brushing teeth or at meal times                
✅           Take care to remove all plaque on and between the teeth and at the gum line.
 
✅            Clean dentures and remove overnight
 
✅             Book appointments at the time of day that is best for the person.          
 
✅              Visit the dentist regularly, sooner if any changes in the mouth or behaviour are noted.
 
 
Adapted from the University of Adelaide Colgate Dental Education Programs “Dental care for people with disabilities information for carers”.

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