{"id":174,"date":"2016-10-03T22:45:47","date_gmt":"2016-10-03T21:45:47","guid":{"rendered":"http:\/\/www.craigentinny.co.uk\/dental-advice\/?p=268"},"modified":"2019-06-14T12:54:47","modified_gmt":"2019-06-14T11:54:47","slug":"the-challenge-of-rheumatoid-arthritis-and-dental-care","status":"publish","type":"post","link":"https:\/\/www.craigentinny.co.uk\/blog\/the-challenge-of-rheumatoid-arthritis-and-dental-care\/","title":{"rendered":"The Challenge of Rheumatoid Arthritis and Dental Care"},"content":{"rendered":"<p>Rheumatoid Arthritis is a difficult condition to live with, as I don&#8217;t suffer from this myself my description probably does not do \u00a0justice to the impact that this disease has. I have many patients, friends and family who do suffer from it and this post is just a few ideas and suggestions that might make maintaining good home care a little bit easier for anyone with reduced dexterity be it as a result of arthritis or any other condition.<\/p>\n<p>We recognise the need to clean <strong>around<\/strong> the teeth and <strong>between<\/strong> the teeth. 2\u00a0 &#8220;separate activities,&#8221; \u00a0for which 2 separate sets of tools are needed. \u00a0 Lets start with the easy one brushing.<\/p>\n<h6><strong>Brushing Choices<\/strong><\/h6>\n<p>Modern electric brushes solve a lot of problems, their handles are thicker than manual tooth brushes and generally they do most of the hard work. There are 2 main types<\/p>\n<p>The oscillatory type &#8211; these have a round head that rotates a few degrees back and forwards<img loading=\"lazy\" decoding=\"async\" class=\"alignleft\" src=\"https:\/\/cdn.cassini.pgsitecore.com\/en-us\/-\/media\/OralB\/Images\/Products\/OralbVitalityFlossActionRechargeableElectricToothbrush\/GroupImage\/Oral-BVitalityFlossActionElectricRechargeableToothbrush_1200.png?w=460&amp;v=1-201509242031\" alt=\"Oral B Rotary electric toothbrush\" width=\"157\" height=\"157\" \/> to create a rotating scrubbing motion. These were made popular by Oral B who still have an extensive range of brushes available to day although other manufacturers so now produce very similar brushes.<\/p>\n<p>The second type of brush is the &#8220;sonic&#8221; type where tiny micro movements are sent through the toothbrush bristles so there is less visible motion on the head of the brush. \u00a0The most commonly brand of this type is Sonicare. The sensation with sonic brushes is definitely different to a manual or indeed an oscillatory brush and can to some people be an acquired taste.<\/p>\n<p>Manufacturers will all claim\u00a0that their brush technology is best and also highlight that the more you pay the more features the brush will have. \u00a0Most of the additional features may make brushing more fun \/ less boring, \u00a0but few of these &#8220;add on&#8221; tricks\u00a0will make a quantum difference to the results you achieve. My advice is always &#8211; choose the type that you like best and then look for a low cost model with a 2 minute timer ( as this is probably the single most important add on \u00a0feature)<\/p>\n<h6>Cleaning Between The Teeth<\/h6>\n<p>This is a trickier area and for most patients it starts with trial and error. \u00a0I cannot recommend one device that will work for everyone but I can suggest a range of things that we have found work well in the hands of our patients.<\/p>\n<p>The first thing to say is that mouthwashes that claim to swirl between the teeth, simply won&#8217;t do the job on their own despite the marketing hype!<\/p>\n<p>Long handled interdental brushes<\/p>\n<p>These are great for most sites and the version \u00a0with the\u00a0\u00a0longer handle are ( for most people ) easier to use than the shorter ones. The extended handle is relatively narrow \u00a0which can make it a <img loading=\"lazy\" decoding=\"async\" class=\"alignleft\" src=\"http:\/\/www.tepe.com\/fileadmin\/uploads\/2012_redesign_files\/Products\/IDB\/neck_popup.jpg\" alt=\"\" width=\"168\" height=\"168\" \/>little harder to grip but this can be easily overcome with a customised handle. \u00a0Dental impression material works very well for this and your hygienist or dentist \u00a0should be able to rattle one of these up for you relatively quickly. Brushes are generally regarded as better than floss at cleaning between teeth so if you have spaces that are large enough to allow it these probably should be your first choice.<\/p>\n<p>Flossing Devices<\/p>\n<p>The best devices have a bow type arrangement and \u00a0there are many of these on the market. Rather than recommend a specific make there are so<img loading=\"lazy\" decoding=\"async\" class=\"alignleft\" src=\"http:\/\/www.hofland.co.uk\/Photos\/Hope%20After%20Stroke\/commercial%20aids\/Crest%20glide%20floss%20pick.jpg\" alt=\"\" width=\"219\" height=\"146\" \/>me key things you should look for. \u00a0I think that this type of arrangement works best. When you put this in your mouth and place it towards the back teeth the floss is already orientated the right way and will be much more likely to fit inbetween the teeth. Devices that look a bit like a fiddle bow are not so good for the back teeth \u00a0( Which is where it is really important to get access.)<\/p>\n<p>Many patients with reduced dexterity harv told me that \u00a0they can help the floss get through the tight contact with a gentle bit of pressure from the opposing teeth. While we don&#8217;t recommend \u00a0\u00a0&#8220;biting \u00a0to floss &#8221; normally this may make the difference between getting in to the back teeth and not.<\/p>\n<p>The type of floss that the bow is threaded with is also important, where possible look for a monofilament \/ one that will break cleanly. The last thing you want to end up with is shreds of floss wedged between the back teeth.<\/p>\n<h6>Ask us for help<\/h6>\n<p>My\u00a0most important piece of advice is to be sure to\u00a0ask us to help \u00a0if you are struggling to get in with floss or brushes. \u00a0Te team are always there to help and have lost of samples on hand \u00a0so that you can go rapidly through the trial and error process while you are with us.<\/p>\n<h6>Mouthwashes<\/h6>\n<p>Finally just a quick word about mouthwashes. \u00a0They can be useful, particularly if you are experiencing a higher rate of tooth decay. Many medications interfere with saliva production and can\u00a0\u00a0leave your mouth dry. The lack of saliva means that any sugar in your diet will hang around for longer \u00a0and consequently have the potential to cause more damage. It is not uncommon to see someone who starts a \u00a0programme of complex medication suddenly developing tooth decay on parts of their teeth were there was none before. \u00a0I will cover this in more deail in a future blog post \u00a0but for now the key messages in relation to mouthwash are &#8211; choose a fluoride containing mouthwash, choose an alcohol free mouthwash, and use it after you have brushed and cleaned in between the teeth.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Rheumatoid Arthritis is a difficult condition to live with, as I don&#8217;t suffer from this myself my description probably does not do \u00a0justice to the impact that this disease has. I have many patients, friends and family who do suffer from it and this post is just a few ideas and suggestions that might make &hellip; <a href=\"https:\/\/www.craigentinny.co.uk\/blog\/the-challenge-of-rheumatoid-arthritis-and-dental-care\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">The Challenge of Rheumatoid Arthritis and Dental Care<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-174","post","type-post","status-publish","format-standard","hentry","category-blog"],"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO 5.0.3 - aioseo.com -->\n\t<meta name=\"description\" content=\"Rheumatoid Arthritis is a difficult condition to live with, as I don&#039;t suffer from this myself my description probably does not do justice to the impact that this disease has. 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