Overcoming challenges

The skills and strategies used when providing support can have a big influence on the success of a person’s daily mouth care routine

Supporting someone with their mouth care can definitely have its challenges.

It’s ok not to do a perfect job! The most important thing is that you have a go. Be patient, keep trying and ask for help when you need it.

Here are some strategies you can try:

General strategies

Know how the person likes to be supported
Where daily mouth care takes place and how it is done may be important factors to encourage participation. A person’s oral health care plan should tell you a lot about this.

Don’t be afraid to ask for more information – ask the person, other supports, family members; anyone who knows the person well.

Build trust
Assisting someone with daily mouth care can be a very personal activity. Having a good relationship will help. If you are supporting a person for the first time, just introducing yourself, using their name and explaining what you are going to do can be a good starting point.

Good communication
Good communication can help a person understand the importance of daily mouth care and reduce anxiety.

Good communication during the mouth care routine can include:

  • Moving slowly and calmly
  • Breaking down the activity into simple steps
  • Calmly repeating instructions if needed
  • Asking one question at a time and allowing time for the answer
  • Using praise and encouragement
  • Using positive non-verbal communication, such as smiling or gentle touch
  • Communicating in the most appropriate way for the person. This may mean simple language, images, demonstrations or a combination of different approaches.

Be patient
It will take some people longer than others to become comfortable with a daily mouth care routine.

If needed, consider a slower process of familiarisation with the routine and tools used. You may start by talking about the steps involved or asking the person to hold or play with the toothbrush, and then slowly work up to doing different parts of the routine.

A gradual familiarisation process can also be useful for preparing for positive dental visits when people are anxious.

Specific strategies

You may have already used some of these to find a way through other challenging situations.

Verbal prompts

If the person gets distracted, remind them what they need to do next.

Distracting

Using singing, music, holding items, gentle touch and talking to distract the person from a challenging situation.

Bridging

Aims to improve the sensory connection and task focus by having the person hold the same object as the support person (eg, a toothbrush) while the support person brushes.

Hand-over-hand

The support person’s hand is placed over the person’s hand to guide them.

Chaining

The support person starts the activity and the person completes it.

Resucing

A familiar other rescues the support person providing mouth care support.
For example, the person won’t open their mouth to brush their teeth. A familiar other could suggest “Come on Alex, you can open wide like you do when I brush your teeth”.

Never use force

If the mouth care routine isn’t working for any reason, stop. Try to work out what the problem might be and see if it can be overcome.

If a person repeatedly refuses to take part in daily mouth care, see if someone else in the person’s support network can help. A behavioural or occupational therapist may also be able to help.

Sometimes people refuse mouth care because of pain in their mouth. If you think this might be the case, make an appointment to see an oral health professional.

Remember

  • Every person is different. The same person can be different on a different day. Be prepared to try a number of different approaches.
  • If you are having problems, speak to someone who may be able to help – a manager, another staff member, a health professional.
  • Share what works and what doesn’t work with other supports.