Step 3: Consider Additional Strategies for Special Patients

One group of patients that need additional attention are those with dry mouth. In addition to brushing, interdental cleaning, use of fluoride, and compliance with commonly recommended diet modification tips, patients with dry mouth can benefit from sipping water all day long, and restricting intake of substances that increase dry mouth such as caffeine-containing drinks. Most will also benefit from saliva substitutes in the form of sprays, lozenges, or mouthwashes, some of which contain fluoride.2,3

Another group of patients that need additional attention are those who cannot care for themselves, due to illness or age. Many may have a diet that increases caries risk: for example, they may eat soft foods for easier chewing and swallowing, receive medications that come in the form of syrups containing sugar, or they may not frequently consume tooth-helping nutrients such as calcium and vitamin C. In addition, they may have caregivers who are not very oral-hygiene aware, or they may not want or be able to ask their caregivers for help in cleaning their mouths. One study found that only 5% of elderly occupants in residential homes asked their caregiver for help in cleaning their mouths.13,14

Other patients who may need slightly different strategies than the general population include those with tooth sensitivity due to dentin exposure who may need toothpaste for sensitive teeth. Those who have hardened calculus deposits (tartar) may need additional help with tartar control.2