For people with HD, it is important to maintain healthy teeth and gums. While HD does not make tooth decay and gum disease more likely, it can make dental care more difficult and increase chances for problems.
There are several reasons why dental issues require special care for people with HD. Uncontrolled muscle movements make holding a tooth brush and flossing more difficult. Complying with dentists and hygienists is difficult or impossible. Uncontrolled muscle movements can also make it harder to keep dentures in place. High calorie diets typically contain a lot of sugar and sugar is very good at decaying teeth.
Possible dental conditions include:
- Bad breath
- Increased germ in mouth
- Increase risk for aspirating these germs into the lungs
- Toxins and acid in the plaque cause gum disease and cavities (decay)
- Uncontrolled gum disease and decay turn into toothaches and tooth loss (and expense)
- Higher risk for heart attacks, strokes, and inflammatory response
Strategies for good dental care
- Using an electric toothbrush
- Antiseptic mouthwash
- Using toothpaste with fluoride
- Single handled flossing aids with large handles
- Receiving regular checkups.
- If swishing is not possible there are toothbrushes capable of suction.
- Dentures need to be removed at night and soaked in a denture cleaner overnight. Brush them after meals.
- For dentures, a suction cupped nail brush allows a patient to use a stable hand to clean the denture
- Develop good dental habits before symptoms begins
Dental Visit Recommendations
- If anxiety and compliance are issues, request an appointment time when your loved one is at their best.
- If bladder control is an issue, inform dentist of need for frequent bathroom breaks or use protective underwear
- Assist with getting into the chair to prevent falls
- If there are airway protection issues, might need double suction, a rubber dam, or sedation
- Ask for a fluoride varnish at every visit
Special Care Dentists
Special Care Dentists are General Dentists with additional training on providing care to people who have active or complex medical issues. A special care dentist typically collects all the medical information to create a comprehensive plan including coordinating with your other healthcare providers. For example, someone with Huntington's disease may have dry mouth due to some medications. Special Care Dentists are trained to discover these problems and find solutions.
Tips for a Home Exam
- Look for signs of discomfort, pus, or fluid lumps by running a gloved finger along the gums between the teeth and cheek.
- Look on the side of cheeks for white curd like deposits that rub off
- Watch for bleeding gums when teeth are being brushed
- Look for plaque at the gum line
- Look for a gum boil
- Look for exposed bone, especially under the denture
- Look for soft overgrowth and report it.
- Use a headlamp to free up hands for the exam
Much of the above Information on oral health care for HD patients provided by Mary H Makhlouf DMD MS PA (www.Docmary.com)