Sound dull? Hang on a minute… oral and dental health is critical to our wellbeing.  All of us, especially those vulnerable to bacterial infections like pneumonia, must brush our teeth first thing in the morning, before breakfast.  Spitting, not rinsing.  Not what you were taught when you were little?  Me neither.  Read on to find out why…

We’re only just starting to learn how connected oral and dental health (and the nearby gut microbiome) is to our overall health. Gum disease is linked to stroke, pneumonia, heart disease, diabetes management and even Alzheimers’. Toothache pain alone can stop us from sleeping, talking and getting enough nourishment and hydration.

Brushing our teeth last thing at night is the most important clean. Overnight our bacteria-defending saliva dries up and ‘bad bacteria’ has the opportunity to multiply. Swallowing the bacteria that has bloomed overnight with our breakfast is bad news.  The bacteria is taken into the gut, absorbed into the blood stream and transported around our body. Eugh.

So if, like me, you were raised to brush teeth after breakfast, we need to rethink.  Brushing before breakfast removes bad bacteria, so any sugar we eat at breakfast can’t feed it and form teeth decaying acid. If we spit rather than rinse at all times, the fluoride in toothpaste protects our teeth against any acids like orange juice too.  A pea sized amount of toothpaste is fine. We should use a small headed tooth brush as directed by our dentist / hygienist, paying particular attention to the gum line. We should also clean our tongue with our toothbrush, thoroughly and gently. If we want to, (zero alcohol) mouthwash will freshen us up again after breakfast. Xylitol chewing gum can help reduce bacteria between meals, since it’s difficult for bacteria to metabolise and multiply.

Dental and oral health is also improved by a healthy diet. If we’re going to eat (or drink) sugar, it’s far better at mealtimes when our saliva levels are highest.  Fizzy drinks, including carbonated water (also acidic), are best drunk with a straw.  This is a challenge if you need high energy sip formulations, when dental hygiene is even more important.

Dental hygiene tips for carers of elders


Some drugs can affect saliva flow and cause a dry mouth, so always have water nearby.

Teeth cleaning can be tricky for elders. A double headed toothbrush can speed things up if you don’t have much time.  For example, I help Marj, but she can tire or become impatient, so we persevere together. The toothbrush should be soft. Brush gently and thoroughly for 2 mins even if gums bleed.  Bleeding gums (a sign of gum disease) should subside once a regular gentle brushing routine is established, it’s worked for us.  If you can manage inter-dental brushes too, well done you (too much for us).

Having the right quantity of fluoride in the toothpaste helps, especially if brushing time is limited. Aim for at least 1,500 ppm (parts per million).  Colgate’s Durophat is available on prescription at higher concentrations, of 2,800 and 5,000ppm for those less able to brush their teeth thoroughly, resistant or incapacitated. There’s no added fluoride in Bucks tap water, you might be interested to know.

A 0.05% fluoride mouthwash (without alcohol) between tooth brushing also helps if brushing is tricky.  Corsodyl can be used to reduce gum disease for 2-3 weeks at a time (it’s an antibiotic and can stain teeth if used for a longer period).  You can also spray it into the mouth, if rinsing is not an option.

Lastly, keep up regular dentist check ups.  Use the NHS website to find a local dentist, NHS or otherwise. You may need to check for accessibility too, perhaps a ground floor surgery.

If, like Marj, visits to a dentist aren’t possible any more, then home visits can be arranged.  Not all procedures are possible on a sofa, but adequate fillings can be done outside the surgery.  Bucks NHS dental home visits are covered by the Milton Keynes branch of the CNWL NHS Trust.  Details of charges are also in the second link.

That’s all my dental tips, do you have any you can share with us?