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Oral Care 101: How To Keep Your Mouth, Gums And Throat Healthy


Good oral care is particularly important after a diagnosis of a serious health condition.

  • Poor oral care can worsen, or even cause, serious health conditions. For example, an infection in your mouth can lower your body's ability to fight your cancer.
  • If you are undergoing chemotherapy, oral care is particularly necessary. 

Following are the guidelines to consider for good oral care,compiled by Eden Stotsky-Himelfarb, BSN, RN.  Below the guidelines is information about paying for, or obtaining free or low cost, oral care.

  • Determine your own needs for oral health care.  Talk with both your dentist and specialist for your health condition about what steps you should take because of your health condition, drugs and/or treatment as well as your overall health. For instance, some treatments increase or decrease the amount of saliva in your mouth.
  • Commit to daily oral health care.
  • Brushing and flossing: 
    • At least twice a day, brush your teeth and gums  - preferably after every meal and at bedtime-- unless your dentists advises otherwise. NOTE: Rinse your toothbrush well after each use and store it in a dry place.
    • At least once a day, clean between teeth with floss or an interdental cleaner. Decay-causing bacteria still linger between teeth where toothbrush bristles can't reach. This helps remove plaque and food particles from between the teeth and under the gum line. NOTE: If your gums are sore or bleeding in places, avoid those areas but continue to floss other teeth until the condition improves.
  • With respect to which toothbrush to use:
    • It is generally agreed that the best toothbrush fits the following:
      • Soft bristles. Soft bristles are best for removing plaque and debris from your teeth without hurting your teeth or gums.
      • A small head. Small heads can reach all areas of the mouth more easily than larger brushes. This is especially so for back teeth, which can be hard to reach.
      • A toothbrush that:fits your mouth, allows you to reach all teeth easily and is comfortable to use.
    • A powered toothbrush may be able to do a better job of cleaning teeth. This is particularly so for people who have difficulty brushing or who have limited hand movements.
    • Replace your toothbrush regularly. A toothbrush should be replaced every three months - or even earlier if it begins to show wear and tear. A worn toothbrush won't do a good job of cleaning your teeth. According to Colgate, a major toothbrush manufacturer, it is also important to change toothbrushes after you have had a cold. Bristles can collect germs which can lead to re-infection.
    • Storage: After each brushing, rinse your toothbrush thoroughly. Store your toothbrush in a dry place. Toothbrushes left to air-dry show significantly less bacterial growth the next day than toothbrushes stored in airtight containers. Capping provides a moist enviornment in which bacteria thrive.
  • How to brush
    • When brushing, use a gentle touch. Brushing too hard can damage soft mouth tissues.
    • If the brush causes pain, toothettes may be used instead. 
    • Your dentist can review with you the best way to brush and to floss. For animations about brushing and flossing: see:  offsite link
  • Toothpaste
    • Use a non-brasive toothpaste with flouride that displays the American Dental Association's Seal of Acceptance. If you cannot afford commercial toothpaste,  mix one teaspoon of baking soda in two cups of warm water. 
    • Avoid toothpastes with whiteners.
    • If your teeth are sensitive, use a toothpaste for sensitive teeth.
    • If your gums are very sensitive, ask your dentist to suggest a special type of toothbrush, floss or dental ribbon, and toothpaste.
  • Consider rinsing your mouth before and after meals and at bedtime. A mouth rinse aids in removing debris and keeping the oral tissue moist and clean.
    • Rinses to consider:
      • Normal saline solution: 
        • Numerous studies have determined that plain salt water is the best and most effective mouth wash available.
        • To make a salinen solution, add 1 teaspoon of table salt to 32 ounces (1 quart) of warm water.
      • Salt and soda: one-half teaspoon of table salt and 2 tablespoons of sodium bicarbonate in 1 quart of warm water
      • A mild mouthwash or a mouthwash with antibiotics to help prevent mouth infections. Speak with your doctor before purchasing and using a commercial mouthwash.
    • How to rinse:
      • Swish the rinse around in your mouth for at least a slow count of 10.
    • Spit out the rinse
  • Keep lips moist with moisturizers other than Vaseline. The oil base in Vaseline can promote infection. 
  • Avoid products that irritate the gums and mouth.  For example:
    • Avoid commercial mouthwashes. They often contain large amounts of irritating salt or alcohol. 
    • Avoid mouthwashes that use alcohol
    • Limit use of dental floss. DO NOT use dental floss if you have platelets below 40,000. (If you do not know the number of platelets you have, ask your doctor or your doctor's nurse).
    • Do not use lemon or glycerin swabs 
    • Do not use toothbrushes that do not have soft bristles
  • Stay hydrated. Drink a minimum of 8 servings (8 ounces) a day.
  • Watch the foods you eat
    • Eat a balanced diet and limit between-meal snacks - particularly snacks high in simple sugars. The amount of sugar consumed at any one time is less important than how often food and drinks that cocontain sugar are consumed.
    • Try to include foods in your diet that are high in protein. 
    • Avoid hot, spicy or acidic foods. They may irrirate sensitive tissues in your mouth.
    • Avoid hard or coarse foods such as bread, chips and crackers. 
  • Avoid alcohol.
  • Do not smoke cigarettes, cigars or pipes. Do not use smokeless tobacco (chewing tobacco and snuff).  For help stopping smoking, click  here.
  • If you wear dentures:
    • Remove the dentures whenever possible to expose gums to air.
    • Do not wear loose fitting dentures. They can irritate the mouth and gums.
    • Do not wear dentures if mouth sores are severe.
  • If dry mouth develops so that you don't have your regular amount of saliva, click here. 
    • Chew sugarless gum to stimulate saliva flow. 
    • If gum doesn't work, consider lubricating your mouth with a synthetic saliva spray, a glycerin swab, or a water-based lubricant.
  • If you develop sores in  your mouth, contact your medical provider immediately. You may need medical treatment.
  • Examine your mouth regularly. 
    • You are in the best position to notice changes in your mouth.
    • It is advisable to examine the inside of your mouth at least once a week.
    • If you notice any changes relating to your teeth, let your dentist know. If you notice changes in other parts of your mouth, let your specialist know.
  • Visit your dentist regularly.
    • Your dentist can advise you how often it is best for you to visit. The optimum frequency of visits varies from person to person.
    • If you haven't had one lately, schedule a dental check up.
    • If you have a cold, it is advisable to throw away your toothbrush after the cold ends so you don't reinfect yourself from germs remaining on the brush.
    • If  you need a dentist:
      • To locate a dentist in your area, see: offsite link, click on "The Public". 
      • For information about how to choose a dentist , click here.
  • If you are going to undergo a treatment, when possible, schedule a thorough dental check up at least two weeks before the treatment begins. 

NOTE: If you develop sores in your mouth (this is called stomatitis), click here. If you have dry mouth, click here. For tips about avoiding infection in general, click here. If the problem persists, speak with both your dentist and your doctor. The difficulty may be due to your health condition, treatment or one or more drugs.

PAYING FOR ORAL CARE: When thinking about paying for oral care, consider the following. 

  • Payment (including free and low cost)
    • Most dentists accept checks or major credit cards in addition to cash.
    • If payment for health care is difficult:
      • Most dentists also offer time over which to pay off the cost by using a special credit card.
      • If the cost of oral care is out of your financial range, consider going to a dental school. The work in dental schools is done by students, but it is supervised by qualified dentists. Also check whether there is a community clinic available. For a list of accredited dental schools, click here offsite link.
    • Also check offsite link (click on "Finding Dental Care")
  • Negotiate It is likely that you can negotiate the amount of the cost of dental care with your dentist. If your dentist won't negotiate, perhaps another equally qualified dentist will.
  • Medical Tourism  If you need expensive care, consider Medical Tourism both within and outside of the United States. "Medical Tourism" merely means traveling to a less expensive place for care. To learn more, see: Medical Tourism
  • Private Insurance Some private health insurance policies pay for dental care. 
    • There are also policies which just cover dental care (known as "Dental Policies"). Dental policies come in a variety of types, just like health insurance policies. To understand terms such as HMO, PPO and Indemnity policies, see our information in Health Insurance 101. 
    • For a directory of available dental policies, see the National Association of Dental Plans' Website: offsite link. Click on "Consumers."
  • Veterans Administration  The VA offers limited dental care.
  • Government Insurance Medicare only pays for oral care in rare circumstances - such as surgery to treat oral injuries from an auto accident. In some states, Medicaid provides dental benefits for adults. However, even in those cases the coverage is severely limited.

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