The oral health of patients with physical and mental disorders requires their maintenance and the dentist’s regular examinations, and the understanding and cooperation of the caregiver is also very important.

Regular Oral Examinations

• In addition to early detection and early treatment, regular examinations can also introduce preventive measures to avoid the occurrence of dental caries.
• Regular dental cleaning and good oral hygiene can prevent periodontal deterioration.

Fluoride Application

• Regular oral fluorination by a dentist every 3 months can prevent dental caries. New fluoride gel is faster and more convenient in use than before, which can quickly finish oral fluoridization without the concerns over excessive swallowing, and has the advantages of efficiency and safety.
• The use of fluoride toothpaste is also effective in preventing dental caries and is generally recommended when brushing teeth in the morning and evening.
• Patients with special needs may use fluoride mouthwash or fluoride gel intended for home use on the advice of their physician.

Dental Treatment for Patients with Mental and Physical Disabilities

• If the patient can be treated by appropriate methods and cooperate with outpatient therapy, it is suggested that the caregiver accompany the patient during the treatment process to ease their anxiety in the unfamiliar environment.
• If the patient is psychologically willing to cooperate and has no severe resistance reaction, but is prone to dangerous movements at the dentist clinic due to factors such as involuntary movement (e.g. patients with cerebral palsy), they can be treated at the clinic with restraining plates.
• If the patient is unable to cooperate with outpatient treatment, whole oral dental treatment under general anesthesia can be arranged after discussion with the attending physician and evaluation by the anesthesiologist.

Proper Brushing

• Patients with physical and mental disorders can be assisted by a caregiver for oral cleaning or, depending on the patient's situation, clean teeth by themselves after guidance.
• When patients with physical and mental disabilities cannot use ordinary toothbrushes smoothly because of weak finger grip, rubber bands can be used to thicken the toothbrush handle, or the toothbrush can be fixed on the patient's wrist with touch fasteners for convenience.
• Patients with poor swallowing function can only brush their teeth with water or squeeze out a grain of toothpaste on the toothbrush to avoid choking.
• As patients with physical and mental disorders often have oral sensitivity problems and the anterior gum area is more sensitive to touch and other movements, they tend to feel discomfort. Therefore, before brushing their teeth, give them a gentle massage with the fingers from the outside to the inside and from the back to the front. Be careful when brushing their teeth and avoid putting your fingers between the teeth to avoid a bite.
• Brushing teeth using a soft bristle toothbrush based on the Bayesian brushing method is recommended.
• Dental floss should be used to clean the posterior teeth crevice to avoid adjacent cavities.

Bayesian Brushing Method

• Aim the bristles at the area where the teeth meet the gums. Brush the upper teeth with the bristles facing up, and the lower teeth with the bristles facing down.
• The bristles meet the teeth at a 45-degree angle. The bristles cover a small part of the gums and press gently against the teeth, giving the bristles a slightly circular arc. The bristles also have a wide range of contact with the teeth.
• The toothbrush moves horizontally over short distances, brushing back and forth about 20 times.
• When you brush your teeth with your mouth open and head slightly tilted, the last tooth in the upper right row can be seen in the mirror. Brush from the right posterior buccal side to the left, then the left occlusal surface, the left lingual side to the right lingual side, and finally the right occlusal surface. There will be no omission if brushing teeth in an orderly way.

The order in which you brush your teeth is, "start on the right, end on the right."

• When brushing the lingual side of the front teeth, straighten the toothbrush to clean the teeth one by one for all corners.
• For the occlusal surface, brush two teeth at a time back and forth.
• Brush the buccal side of the back teeth with the hand on the same side, that is, brush the right buccal side with the right hand, left buccal side with the left hand. The brush handle can hold the cheek open for easy observation.

The procedure is: "Brush the cheek side with the hand on the same side; brush the tongue side with the hand on the other side.

• After brushing the upper row of teeth, use the same principle and method to brush the lower row of teeth.