1. Importance of good Oral Hygiene Sapna Mandalia RDN Oral Health Promoter/Co ordinator London Northwest Health Care NHS Trust Based in Brent Community Dental Services.

2. What we will cover in our session today Why good oral health is important Key Oral Health Messages: Dental plaque Dry mouth Sore mouth Mucositis Importance of using a Fluoride toothpaste Dental decay/Periodontal Problems Tooth erosion Oral hygiene and over coming problems Denture/Obturator care Dietary advice in general Visiting your dentist regularly

3. Oral Cavity

4. Side Effects of Treatment Sore Mouth (Oral Mucosities) Xerostomia (Dry Mouth) Limited/Restricted mouth opening (Trismus /Tissue Fibrosis) Gum problems (Periodontal issues) Metallic taste in the mouth/Altered taste Nausea Difficulty in swallowing (Dysphagia) Rapid tooth structure breakdown can follow radiation therapy (Radiation cavities) And many other oral complications.

5. Sore Mouth Frequent complication of cancer treatment Radiation and Chemotherapy. Painful and debilitating inflammation and ulceration. Patients finding it difficult to eat, speak or tolerate therapy.

7. Home Remedies * Do not use salt if you have mucosities! ¼ teaspoon

8. Dry Mouth Change in taste, mouth sensations; burning mouth syndrome, difficulty swallowing, difficult with wearing dentures. More prone to tooth decay, gum disease, mouth infections. Dry mouth products, available over counter. Sips of water.

9. Dry Mouth Products

10. Impact on oral health Dental Decay Inflamed Gums

11. e DENTAL EROSION

12. Daily Oral care Brush gently using a soft/children’s toothbrush with a Fluoride toothpaste after every meal and at bed time. Clean in between your teeth using a floss, interdental brushes and don’t forget to clean your tongue. Use special brushing techniques if the mouth is sore. Drink liquids and suck on ice chips or sugarless lozenges to relieve dry mouth. Rinse with 1/4 teaspoon each of bicarbonate of soda and salt in a glass of warm water; omit salt during mucositis Keep dentures/obturators clean by soaking them daily in antimicrobial solutions (not overnight!) rinse thoroughly and clean water. Remove prosthesis if any irritation, mucosities, or ulceration occur and let it heal. Visit your dentist regularly

13. Tooth brushes Barman’s Super Brushes ELECTRIC TOOTHBRUSH WITH PRESSURE SENSOR

14. SPECIAL BRUSHES Collis Curve brushes Tip: Prop the mouth open with another large handled toothbrush or two banded together on one side whilst brushing the other side

15. TOOTHPASTES/MOUTHWASHS

16. Fluoride toothpaste on Prescription

17. INTERDENTAL CLEANING

18. USEFUL AIDS TONGUE CLEANING BRUSH TONGUE CLEANER ORAL CLEAN WIPES

19. Looking after your mouth after loosing all your teeth.

20. Denture/Obturator Care

21. Eat a healthy Diet with more fruits and vegetables

22. Suppliers of special toothpastes and brushes Ask your pharmacist they all stock most of the products. Barman’s Super Brushes : AMS international www.amsinternational.net Tell:01777872015, Dent.o.care www.dentocare.co.uk Tell: 08009801517, Amazon www.amazon.comwww.amsinternational.netwww.amazon.com Collis Curve brushes: AMS international www.amsinternational.net Tell:01777872015, Dent.o.care www.dentocare.co.uk Tell: 08009801517, Amazon www.amazon.comwww.amsinternational.netwww.amazon.com Biotene Products: www.amazon.com Boots Pharmacy or all Pharmacies can order for youwww.amazon.com Oranurse unflavoured toothpaste: RIS Products LTD 0143884135 sales@risproducts.co.uk, AMS international www.amsinternational.net Tell:01777872015, Dent.o.care www.dentocare.co.uksales@risproducts.co.ukwww.amsinternational.net Tell: 08009801517, Amazon www.amazon.comwww.amazon.com BioXra : RIS Products LTD 0143884135 sales@risproducts.co.uk, www.amazon.comsales@risproducts.co.ukwww.amazon.com Pronamel by Sensodyne, Colgate, Colgate Fluoriguard (Mouthwash), Interdental cleaning devices : Available in all chemists and large supermarkets Oral B electric toothbrushes and heads: Supermarkets, Pharmacies, Amazon www.amazon.comwww.amazon.com Please note that all toothpastes/Mouthwashes I e Oranurse, BioXra, Duraphat 2500ppm or 5000ppm, Biotene, Fluoriguard are available on prescription I went to various pharmacies on Kenton Road, Belmont Circle and Stanmore to check and they all have confirmed.

23. Thank you so much for listening. Any questions?