3-3-1-Physical Symptoms and Responses

Convulsions occur when a person’s body shakes rapidly and uncontrollably and can result in chipped or broken teeth.

Causes include:

• Epilepsy
• stroke
• head trauma
• brain tumor

Common medications for seizures can cause overgrown gums, bleeding gums, and dry mouth. Irritated gums increase the risk for oral infections and sores.

Support the person as needed while maintaining respect and encouraging independence.

If assistance is required, elevate the person’s head in bed or in a wheelchair.

Consider the following:

• Person’s ability for rinsing, spitting, swallowing, etc.
• Need for toothpaste vs. rinses
• The need for a suction brush

When providing care to an unconscious person:

• Turn them on their side
• Put a towel under the cheek
• If needed, place a basin under the chin and cheek to catch excess moisture

Dampen a single use mouth swab or toothbrush with artificial saliva/water/alcohol-free mouth rinse, gently apply to teeth, gums, tongue, and inside surfaces of mouth.  This will moisten the lips and mucous membranes prior to providing oral care to help prevent added trauma to oral cavity.

Dysphagia is difficulty swallowing. It may be necessary to use water or an anti-bacterial mouth rinse on the brush instead of toothpaste.

If a person has dysphagia it is important to clean excess food and debris from the person’s mouth to prevent aspiration.

Utilize swab, gauze wrapped fingers, or suction toothbrushes (which aspirates saliva and toothpaste foam as it brushes).

As people age, and if a person has had a stroke, food does not always clear the tongue. This causes pockets of food to collect inside cheeks.

Consider this:

• Excess food needs to be cleaned before brushing
• Use a single use mouth swab or gloved finger
• This must be done before bed

This condition may make it difficult to handle a toothbrush.

Many adaptations are available:

• Having a bicycle grip on toothbrush handle-filled with plaster to make it solid
• Insert brush in rubber ball or Styrofoam ball
• Put brush in roll of foam rubber
• Secure nail scrub brush handle to the toothbrush handle (remove bristles of scrub brush)
• Attach a Velcro strap to brush handle