Oral hygiene and saliva management Akuaku ā-waha me whakaritenga hūare

Oral hygiene is important for everyone, particularly people who have swallowing difficulties.

Your saliva (which contains bacteria), food and liquids can go into your airway. This is called aspiration. This may increase the risk of a lung infection.

Oral hygiene is also very important for people who cannot eat and drink (nil by mouth).

Illness or medication can affect the cells that line your mouth. They can also cause unpleasant side effects such as:

• changes in taste
• sore or bleeding gums
• dry mouth.

They can also cause: 

• oral thrush
• redness
• swelling
• ulcers.

Taking good care of your mouth will help stop this happening.

You may have a dry mouth or excess saliva. Your saliva can be runny, or it can be thick and stringy. You may find it difficult to swallow your saliva. This can lead to drooling, especially if your facial muscles are weak.

Dry mouth

• Brush your teeth at least twice a day with a soft toothbrush and toothpaste containing fluoride.
• Brush your gums and tongue.
• After brushing, swish and spit the toothpaste out but do not rinse.
• Make sure there is no food left in your mouth after meals. Check in your cheeks, your teeth, under your dentures and on your tongue. You may need to do this after every meal.
• Between meals, try to avoid sugary food and drinks, especially fruit juice, soft drink and cordial. If your dietitian or healthcare provider has recommended you have oral nutrition supplement drinks between meals you should continue to have these.

• Brush your dentures with soap and water after each meal. Leave your dentures out of your mouth at night. Soak them in a denture cleaner such as Polident or Steradent.
• Take your dentures out if you are applying a cream or gel in your mouth.
• If you have a mouth infection, it is important to soak your dentures at night. Otherwise, the infection can remain on your dentures. You can use chlorhexidine mouthwash to clean dentures. Or you can soak them in quarter-strength Milton antibacterial solution. You can buy these at your pharmacy.

• Regularly sip water or other cool drinks.
• Reduce alcohol, drinks containing caffeine and smoking.
• Use a saliva replacement. Talk to a pharmacist about mouth moisturisers or lubricants and other dry mouth products.
• Use salt and baking soda mouthwash after every meal or as you need it. Make it with ½ teaspoon of salt and ½ teaspoon of baking soda dissolved in 200 ml water. Make it fresh every day and keep it in the fridge.
• Chew sugar-free gum.
• Suck ice cubes or crushed ice.
• Keep your lips moist with petroleum jelly (Vaseline) or lip salves.

• Drink more.
• Try a steamy shower or steam inhalation.
• Sip soda water. This can be thickened if necessary.

• Have frequent dry swallows (swallowing without drinking anything).
• Have regular sips of liquid.

Medical treatments are also available to help with saliva changes. Talk to your healthcare provider about the options.

Talk to your dentist, pharmacist or radiation team about a suitable mouthwash.

Chewing gum

Chew sugar-free chewing gum, preferably containing xylitol. You can get this from a supermarket or pharmacy.

Moistener, lubricating gel or artificial saliva

Talk to your dentist or pharmacist about using oral lubricants such as Denta-Med Dry Mouth products, GC Dry Mouth Gel or Biotene Oral Balance. Try coconut oil.

Other remedies

• Add 1 drop of peppermint essence to 100 ml of grapeseed oil and apply a drop or 2 to your mouth when it starts to get dry.
• Suck crushed ice.

You should also talk to your dentist about how to protect your teeth from the dental decay that often happens when you have a dry mouth.