11 Tips for Getting Your Teeth Cleaned with Rheumatoid Arthritis
Getting your teeth cleaned can be difficult
when you have RA and particularly if it affects your neck and jaws. Although
the concept of lying in the dentist’s chair sounds comfortable (well, except
for the part about being at the dentist), it can be just the opposite. The little
divot for your head is guaranteed to make your neck hurt, but your visit to the
hygienist can be even harder for your jaws. Keeping your mouth open for 45 minutes
or more while someone pokes at your teeth can make your jaws flare. But
there are ways to make the visit easier.
Talk
first. Start off with a conversation about your RA
and what it means for the state of your teeth in general, as well as getting
your teeth cleaned. RA in your jaws and shoulders/elbow/hands can make brushing
difficult, which can affect the health of your mouth and teeth. As well, taking an
immunosuppressant may inflame your gums, as it gets more difficult to fight
back against the bacteria in your mouth. Explain that keeping your mouth open
for a long time hurts, and you may not be able to open your mouth as wide as
other people. If your hygienist (and/or your dentist) doen’t understand this, or
doesn’t work with you in a way that respects your RA, get another dentist!
Take
painkillers. We all hope seeing the hygienist won’t
hurt too much, but assuming that it will can actually reduce that pain. Take
your medication before you go to your appointments, timing it so it starts to
work 10-15 minutes into your appointment. This can make the entire
experience much less painful, and the meds will still work when you walk out the door. If
you hurt a lot after having your teeth cleaned, make sure you take the
painkillers on a regular basis for the next couple of days.
Bring
a pillow. Bring a small pillow that you can put
between your head and that awful divot in the dentist's chair. Find a pillow
that’s small enough that it won’t get in the way, but with enough cushiness
that it can offer you a bit of support. This will make your neck happy, which
will make you happy.
Take
breaks. Before you get started, tell the hygienist
that you will likely need some breaks to rest your jaws. Agree on a signal,
such as raising your hand, that will give them the cue they need to back off
for a bit. During those breaks, gently move your jaw to ease the strain on the
muscles. Closing your mouth and trying to relax your jaw muscles can also be really
helpful. Go easy on yourself, don’t do anything that doesn’t feel good. A mouth prop
may also help.
Clean
in quadrants. You have four quadrants in your mouth:
upper right and left, and lower right and left. The hygienist will clean the
inside and outside of your teeth. Getting the inside cleaned requires opening
your mouth wider than the outside. Ask
the hygienist to alternate between the inside and outside of different quadrants. This
will enable you to naturally rest your jaws throughout the procedure.
X-rays. X-raying your teeth identifies potential cavities before they
become the size of a meteor crater. X-rays are also really difficult
if you can’t open your mouth very wide. The contraption into which the x-ray
film is inserted (or which is a conduit for the digital x-rays) is made for
people with normal mouths. Ask for the children’s version. It’s smaller, and
much easier to get in position without straining your jaws.
A successful visit to the hygienist also depends
on what you do in between appointments. Taking care of your teeth can make
getting your teeth cleaned a much easier process, as well as limit the times
you have to see the dentist. You know this already, at least in theory. But
it’s hard to do. Here are a couple of tricks that will make it easier.
Get
an electric toothbrush. You can get the
battery-operated kinds, or the electric. The former is cheaper, but may have to
be replaced more often. If you have trouble opening your mouth, get an electric
toothbrush with a round brush head, as opposed to the oblong or rectangular
brush head that mimics a regular toothbrush. The round brush head doesn’t
require as much space.
Floss. Yeah, sure. Tangling the floss around your fingers and moving your
arms and hands to floss is difficult, nevermind how far you have to open your mouth. For many of us, flossing becomes
optional. It doesn’t have to be. Get yourself a flossing wand, such as this one
Use
a sulca brush. This is a fantastic tool that can
help you clean along your gumline, removing buildup that can turn to tartar,
which in turn can lead to cavities and periodontal disease. It’s quite long,
which makes it easier to get to your teeth if your arms are aching. Wrap a bunch
of rubber bands around the handle to make it thicker and easier to grip.
Soft-Picks. These little things are quite literally a miracle (I just
discovered them, so forgive the enthusiasm). They are a fantastic help to get at
food that’s stuck between your teeth. They are also an excellent tool to
supplement or replace flossing, if that’s hard for you.
Q-tip for size comparison
You stick them between
your teeth at the gumline and move them back and forth. Because of the tiny
teeth on the green part, they not only remove errant food, but also build-up,
which can lead to tartar, etc. One drawback is that they’re quite small, but it
that can help you with that boring exercise of making sure your thumb can meet
the tips of the other fingers.
Note: you don't have to floss, use the sulca brush, and the soft-picks every day if that's too much for you, but try to do at least one, in addition to brushing your teeth. It'll go far towards making your teeth and gums healthier.
See
your hygienist every four months. RA affects the
health of your mouth in two ways. One, it’s difficult to take care of your
teeth because of the pain and limited mobility in your jaws and
shoulder/elbows/hands. Two, both the RA, as well as the medications used to treat
it, can impact the health of your gums. Seeing a hygienist every four
months, rather than the recommended six, can do wonders for cavity prevention,
as well as staying ahead of periodontal disease.
What is your experience with pain and
getting your teeth cleaned?
Neither GUM nor Oral-B paid me to say nice things about their products. I'm just a happy customer.
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