Overview
Dysphagia is the medical term for swallowing difficulties.
A clean healthy mouth is important for everyone, but especially those who have difficulty swallowing.
Regular mouth care:
- ensures good oral health
- helps with comfort
- reduces the risk of respiratory infection
Mouth care is equally important for people who have no natural teeth and is essential even if the person does not take any food or fluids by mouth.
Advice
General advice
When helping someone with difficulty swallowing to care for their mouth, it is important to understand what is best practice.
You can also get advice and support from dental and other health professionals.
Exposure to sugars
To avoid prolonged exposure of the teeth to sugars, ensure any food, fluid, or tasters are cleared from the mouth.
Positioning
Tilting the chin forward during mouthcare will help ensure any excess fluid drains to the front of the mouth.
Take it slowly
Some people with swallowing difficulty may struggle to receive mouth care.
Techniques such as massage or gradual introduction of the toothbrush and toothpaste may help.
Toothbrushes
Teeth should be brushed at least twice a day with fluoride toothpaste, though people who have difficulty swallowing may need mouth care more frequently.
- For someone with a small mouth or where access is difficult, a child sized brush may be helpful.
- An electric toothbrush with a small round head may be preferred for some people. There may be increased splatter with an electric toothbrush which requires additional caution in someone with a severe swallowing difficulty.
Soft toothbrushes
These are useful when tissues in the mouth are tender or sensitive – for example, with end of life care or for a patient undergoing chemotherapy.
They are available in adult and child sizes.
Suction toothbrushes
These help to reduce the amount of fluid in the mouth during brushing as well as removing debris and secretions.
They can be helpful for people with severe swallowing difficulty.
Specialised brushes
Other types of brushes are available for specific circumstances.
A dental professional can help advise on the options available.
Non-foaming toothpaste
Mouth props
These are used to help gain access in people with teeth who may have trouble keeping their mouth open.
They protect from involuntary biting and the individual can rest teeth on them to help hold their mouth open comfortably.
A dental professional can help advise on the options available.
Soft tissue mouth care
Care of the soft tissues of the mouth is also important to help keep them clean and moist.
There are a number of products available that are useful for soft tissue mouth care.
Find out more information about these products.
Soft tissues can be cleaned using non-fraying gauze dampened with water or saline wrapped round a gloved finger.
An ultra soft or silk toothbrush may also be helpful or a brush with a 360 degree head.
Tissues of the mouth and lips can be moisturised using water-based gel or artificial saliva.
Important
Do not use:
- sponge swabs – the sponge head may become detached which poses a choking risk
- petroleum-based moisturisers – they can cause damage if inhaled and are flammable