15 February 2011

Oral Hygiene: Going Overboard

Once in a while, I get desperate about Vera's oral hygiene. Or lack of it.

There are yellow patches in between her teeth. Plaque. I smell her bad breath and see a yellow-caked tongue. Then I get carried away.

The last time, I whipped out the toothette (oral swab) and started cleaning away. Her secretions increased significantly, a sign of micro-aspiration*. Lots of suctioning ensued.

Yesterday, I whipped out the finger brush and even put toothpaste on it. She must have swallowed the bubbly and micro-aspirated again. She'll be dealing with lots of phlegm in the coming days.

You'd think that I'd learn but I don't know why I don't.

*Micro-aspiration means some fluid gets into the lungs, and this causes more phlegm to be produced by the body.
p.s. Anyone has any ideas? She refuses Spiffies toothwipes, and clamps down on our finger so hard it's painful even if we're wearing the rubbery finger brush.

6 comments:

connie said...

My suggestions - some you will think I'm insane for. One was that I purchased some dental scalers (like dental hygienists use to clean teeth) and in tiny sessions (a minute every day or so) I would talk to her and take off a little plaque. Eventually it was gone. I had to be patient, which was hard because I was like you and wanted it done in one day. Also, I HAD to learn to explain to her what i was going to do. I'd say, "I'm going to brush your teeth." And then I'd say it again, so she had time to hear, process, and prepare herself for what I was going to do. Then I'd use the toothbrush (usually just water) and count. I think I only counted aloud to 6 or 10 or something. Whatever was the number I counted to (and I cannot remember today), I ALWAYS stopped brushing at that number. So she very quickly learned not to bite/gag/panic, because always at that number, it was like a promise to her that I was going to stop, and she could relax and breathe and trust me that I was not going to do it again without proper warning. Saying it twice really helped her (I think) learn not to panic every time I announced something. And sometimes, she just couldn't accept what I wanted to do, and I decided it wasn't giving her a time-sensitive medication or something, so I could be sensitive to what she was feeling and telling me that time ... and I would let it go, and just tell her it was ok and hold her and do something else.

connie said...

Oh, and I probably didn't get to this point till she was way more than a year, maybe 2!! We tried things like electric toothbrush (and ripped her frenulum ... the band of tissue where the lip attaches to the gum ... in our efforts. And had lots of gagging and tears. It took me forever to realize if I slowed down and calmed myself down, she might be more willing - and she was. (So it's never too late to start.) And I should admit that I pretty much never did anything consistently, or consistently well, either. I found this worked, but I was worse than most at doing things really consistently, so please don't assume that. That's why I feel I should never give advice. My real, true advice would be that you should never think you aren't doing things well enough. You are the parent chosen for this little girl, so you ARE good enough, and you love her, and that IS enough. The rest is just extra to fix the things you think you wish you were doing better, but no pressure. Teeth became one of my obsessions because eventually, the plaque was there, and I had heard so many parents say their child had to be put to sleep for cleanings. So I figured something out, especially because I thought if I could get the plaque off, and a way to brush better, then we could AVOID the whole extra going-to-sleep thing. But before that, there was figuring out apnea, feeding, diaper rashes, suctioning, ... good thing teeth could wait.

I hope your family is doing well.

Anonymous said...

Hi May,
I do this with Charmaine. I'd sing her the modified version of 'Mulberry Bush Song' whenever I brush her teeth. The replaced lyrics goes like this "This is the way I brush my teeth, I brush my teeth, I brush my teeth, This is the way I brush my teeth so early in the morning".

She gets carried away with the song & eventually developed a routine. She opens her mouth wide for me to brush and I get to brush for as long as 3-4 repeats of the song. She enjoys it a lot!

Yvonne

Serene Ho said...

Jonathan's mouth has been sensitive since young. so plague definitely accumulate. His last cleaning was more than 3 years ago and that was when he was under GA. We go to the national dental centre for half yearly check cos the doctor there specialises in children with special needs. Now when he goes there, he does open his mouth a little so that she can see his teeth. She doesn't do cleaning cos Jonathan doesn't like the sharp tool. Going there helps me a lot because the dentist can tell me how many baby tooth there are left before they drop off and gives me advice on what to do. She encourages electric toothbrush to reduce the sensitivity. I do that and notice that Jonathan's not so afraid even though he doesn't open his mouth wide enough. sometimes the plague comes off by itself so i'm not really bothered. Now Jonathan can actually spit water whenever we give him a teaspoonful to rinse his mouth. if he doesn't, normally he will just lower his head so the water trickles out. Maybe try the electric toothbrush first but don't use the hard bristles brush. start with her cheeks and just brush in circular rotation. that will give her a fuzzy sensation and slowly her mouth will become less sensitive. When that improves, use a small head brush and start with her teeth and gums. Don't use alot of toothpaste. start with a pea size lump first. otherwise, her mouth will be full of toothpaste foam and she will tend to swallow them. I don't use children toothpaste for Jonathan because somehow with the fruity flavor, it causes secretion for him. so I stick to colgate. Hope this helps and you will find a way to clean Vera's teeth easily.

Cathy said...

Obsession is an understatement. I am also reading all this advise. Even though Annabel lets us brush briefly I see this yellow plaque also and can't stand how it looks. My dentist at home didn't want to put her to sleep. He said just bring her in on his day off and he would clean well. He was so rough, she screamed and her mouth bleed terribly. I would happily sedate Annabel to get all this plaque off. Good luck and let us know what works for Vera.

mybabybunny said...

I have e same prob with mathias. I brush twice a day but there's still tons of plaque. Annoys me no end. I usually tilt him to his side so Tt he don't ingest e toothpaste. N after I use a clothe to wipe out any residue. He obviously fights me so I have to be fast. Hehe.