Absolute Dental Centre

At the beginning of 2011, the main focus on research has been on very diverse areas including , managing patients with chronic myeloid leukaemia and trying to find helpful, practical solutions for patients who need help due to reduced manual dexterity.
Chronic Myeloid Leukaemia
Immunodificiency is a state whereby the immune system becomes less efficient, making an individual more susceptible to infection. As a result, some medical conditions or the treatment for them can have quite a deterimental effect on the health of the mouth. One of the conditions which can present symptoms in the mouth is myeloid leukaemia. This condition is cancer of the blood cells in the bone marrow which produces stem cells. These are known to be important for the production of white blood cells which help the body fight infection.
How would we recognise the signs and what symptoms may patients complain of?
The signs in the mouth which could indicate this condition are enlargement of the gingivae, bleeding from the gingivae and also lips and pallor to the lips and gums. Angular cheilitis at the corners of the mouth and glossitis which is inflammation of the tongue may also occur. There may also be an increased risk and rapid deterioration of periodontal disease.
Symptoms patients may have experienced include leukaemia, fatigue, loss of appetite, weight loss, abnornal bruising and bleeding. They may also complain of a sore and burning mouth.
The hygienist has a crucial role in the oral management of CML, as this condition can go unnoticed for a period of time and could have been contributing to the progression of periodontal disease, but not the cause. The main aim is to stabilise the patients periodontal condition, as the patient will be immunocompromised and their ability to fight infection is reduced. Plaque control is essential for patients who are susceptible to periodontal disease. Some medications used to fight CML can cause xerostomia, where the mouth becomes very dry and sore. Fortunately, there are some very effective mouthwashes available to help make the mouth more comfortable.
Where treatment is concerned, it can be more comfortble to try and achieve the treatment in as few visits as possible, using good instrument techniques to prevent excessive bleeding.
How can we help patients with reduced dexterity?
We know how difficult it can be to clean really well if we have had an injury to our hand or wrist or to suffer from medical conditions such as arthritis or if the patient has had a stroke. For the patient, this can be very debilitating and can lead to a great deal of stress and worry, feeling run down and in turn can impact on the oral cavity sometimes manifesting as oral ulceration.
Some of the solutions we find to helping patients adapt their toothbrushing techniques include:
* Using an electric toothbrush. This can help as these type of brushes remove more plaque than manual brushes and tend to have bulkier handles which are easiser to grip. They also have different types of head to allow for better cleaning in between teeth.
* Wrapping elastic bands round the handle of the brush. This helps provide better grip on the handle. Post office elastic bands work really well for this!
* Blu tac. This is extremely versative and can mould round the handles of brushes.
* Tennis ball. This works really well by puncturing the tennis ball with two holes and sliding the brush through.
* Using floss holders on a long handle to allow for better access
* Impression putty. We have a great putty which is normally used when taking impressions and works particularly well as we can shape it round the brush for you!

Some of the dental companies also produce toothbrush holders and I find the some of the best holders can be found on the Molar web site.
If you find that you are struggling with cleaning, let us know and we will help find the solutions for you!

Written by Maureen Milne