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Medical Forum / General / Dentistry / September 2006

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Brushing frustration

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David Moran - 25 Sep 2006 01:11 GMT
Hi all, I am 22 and have Cerebral Palsy. I notice when I brush my teeth,
my arms shake uncontrollably and it takes me about an hour to do a good
job brushing my teeth. I am in school and quite frankly don't have time
to spend this long brushing. If I am in a hurry, I have a friend or
family member help me (if any are around). I do use an electric
toothbrush and that doesn't seem to help. I've had check ups by 2 or 3
doctors and they all say I'm perfectly healthy. They've suggested muscle
relaxers, which I want to avoid. I don't understand the problem as I can
shave in 5 minutes or less. I try to spend 30 seconds on each quadrant,
but don't know if that's too much or not. Any input would be appreciated.

Thanks.
Dave
mamounjo3@yahoo.com - 25 Sep 2006 02:29 GMT
It might not be practical for you to brush your teeth on a daily basis.
Maybe once per week is the most that you might be able to comfortably
do.  If you can't brush your teeth well, you might consider other
strategies for allowing you to preserve your teeth without brushing.

You could have a dentist perform a professional cleaning once per
month, and said dentist will also check for any emerging cavities.
You could rinse several times per day with a fluoride rinse, like Act
or Flouriguard.  The fluoride helps prevent tooth decay even if you
don't brush your teeth.
Avoid eating sugary foods or stop any kind of sugar consumption.
Especially, don't eat sugary foods that stick to your teeth after you
eat them, like chocolate chip cookies, oreo cookies, snickers bars,
etc.  Sugar, especially sticky forms of sugar, helps promote plaque
growth and build-up.  The main point of brushing teeth is to get rid of
plaque, so if you have less plaque, there is less harm to not brushing
your teeth.
The big thing is not to allow particles of food to get stuck around
your teeth for any period of time.  So, after every meal, rinse with
water.  Always rinse with at least water after every meal to get rid of
any food particles around your teeth.  Keep rinsing until no more
particles come out.  Examine your teeth in the mirror to see if there
are any more particles.
If you never had food particles linger around your teeth and you never
consumed sugary foods, you could literally not brush your teeth at all
and get few or no cavities, especially if you rinse frequently with
flouride-containing mouthwash.
You could also drink authentic Japanese green tea, 1-2 cups per day,
made from green tea leaves and twigs.  Green tea helps reduce plaque
formation around teeth.

In summary, follow the above advice to reduce plaque formation around
your teeth, and use fluoride and get once per month dentist cleanings
to prevent further cavities.  You should be constantly rinsing your
teeth with water after meals if you cannot brush, and then rinse with
fluoride and not eat or drink anything for about 1/2 hour after rinsing
with fluoride.  The best time to rinse with fluoride rinse is at night,
when you are just sleeping for eight hours.  Plaque grows a lot while
people are sleeping, so the fluoride rinse at night helps counteract
the damage of plaque that develops through the night.  especially don't
go to sleep with particles of food stuck around your teeth.  rinse them
out.

> Hi all, I am 22 and have Cerebral Palsy. I notice when I brush my teeth,
> my arms shake uncontrollably and it takes me about an hour to do a good
[quoted text clipped - 9 lines]
> Thanks.
> Dave
Steven Bornfeld - 25 Sep 2006 02:39 GMT
> It might not be practical for you to brush your teeth on a daily basis.

    Maybe yes, maybe no.  But I'd certainly like to know more about the
difficulty before throwing in the towel on daily oral hygiene.  Unless
the OP is resistant to decay and periodontal disease, this could be a
prescription for big problems, and monthly professional cleanings will
not prevent decay (though they might well help the overall periodontal
condition).

Steve

>  Maybe once per week is the most that you might be able to comfortably
> do.  If you can't brush your teeth well, you might consider other
[quoted text clipped - 51 lines]
>>Thanks.
>>Dave
David Moran - 25 Sep 2006 03:08 GMT
> It might not be practical for you to brush your teeth on a daily basis.
>  Maybe once per week is the most that you might be able to comfortably
[quoted text clipped - 52 lines]
>> Thanks.
>> Dave

Personally, I can't afford to get monthly cleanings. I really want to
find a solution to this as it is really frustrating, especially when I
have other things that I need to do as well.

Dave
AdvanceAgent - 25 Sep 2006 03:22 GMT
Hi David,

Try not holding your tooth brush too tightly when you brush.  I tend to
do that thinking the harder I brush the clearer my teeth will be.
Actually you may cause some damage to your teeth if you brush too hard.
Try holding your brush lightly to see if your tremor lessens.

You really need to brush your teeth at least twice a day.  You may be
able to get away with once daily if you rinse with mouth wash during
the day.  But definitely brush before you go to sleep to clean out all
the food you accumulate during the day.

Are you flussing?  That's also very important to keep spaces between
the teeth clean.  That's the most common place for cavities.  It will
be difficult to fluss using your hand.  You may want to use "Y" shape
thing that spread the fluss for you.  What's that thing call anyway.

[AdvanceAgent #367924]

Games I am currently playing:
http://uc.gamestotal.com/?in=367924

> > It might not be practical for you to brush your teeth on a daily basis.
> >  Maybe once per week is the most that you might be able to comfortably
[quoted text clipped - 58 lines]
>
> Dave
AdvanceAgent - 25 Sep 2006 03:24 GMT
I forgot.  Don't miss your 6 month cleaning appointments.

[AdvanceAgent #367924]

Games I am currently playing:
http://uc.gamestotal.com/?in=367924

> Hi David,
>
[quoted text clipped - 80 lines]
> >
> > Dave
David Moran - 25 Sep 2006 03:35 GMT
I'm about 2 1/2 months from my next one. Already have it scheduled!

Dave

> I forgot.  Don't miss your 6 month cleaning appointments.
>
[quoted text clipped - 86 lines]
>>>
>>> Dave
David Moran - 25 Sep 2006 03:34 GMT
I've tried holding it different ways to no avail. Flossing is a disaster
waiting to happen for me. I've tried and it's even harder. I have a few
friends that help me out if I need it, but I'd prefer to find a way to
do it on my own.

Dave

> Hi David,
>
[quoted text clipped - 79 lines]
>>
>> Dave
AdvanceAgent - 25 Sep 2006 03:46 GMT
Instead of the conventional fluss, you may want to use interproximal
brush.  Shown here as an example:

http://www.deplaque.com/

But it comes in smaller sizes and brands available in your local
pharmacies.  The brush goes in and out of the space between the teeth
to clean the space.  No rope.

This may be easier for you.

[AdvanceAgent #367924]

Games I am currently playing:
http://uc.gamestotal.com/?in=367924

> I've tried holding it different ways to no avail. Flossing is a disaster
> waiting to happen for me. I've tried and it's even harder. I have a few
[quoted text clipped - 86 lines]
> >>
> >> Dave
Steven Bornfeld - 25 Sep 2006 02:36 GMT
> Hi all, I am 22 and have Cerebral Palsy. I notice when I brush my teeth,
> my arms shake uncontrollably and it takes me about an hour to do a good
[quoted text clipped - 9 lines]
> Thanks.
> Dave

    I'm confused.  Are you saying that you spend 30 seconds per quadrant,
but you feel it would take an hour to do a good job?  Is this an
intention tremor?  I cannot understand why you can shave so quickly but
cannot brush even with a mechanical brush.  Maybe you can elaborate on
what part of the brushing motion seems to evoke the tremor.  Better, it
would help to demonstrate your technique to your dentist, who may well
have some ideas on how to make things less stressful.

Steve
David Moran - 25 Sep 2006 03:04 GMT
>> Hi all, I am 22 and have Cerebral Palsy. I notice when I brush my
>> teeth, my arms shake uncontrollably and it takes me about an hour to
[quoted text clipped - 20 lines]
>
> Steve

I really don't know. What I end up doing is brushing one quadrant, take
a break, go back and do more, etc. It seems like I have the most trouble
brushing my front teeth. I wonder if part of it might be that I try so
hard to relax beforehand that somehow it makes the tremor worse.

Dave
Steven Bornfeld - 25 Sep 2006 03:19 GMT
> I really don't know. What I end up doing is brushing one quadrant, take
> a break, go back and do more, etc. It seems like I have the most trouble
> brushing my front teeth. I wonder if part of it might be that I try so
> hard to relax beforehand that somehow it makes the tremor worse.
>
> Dave

    As a dentist, I would like to see you brushing your teeth, and see if I
can see where the difficulty is.  I'm inclined to think a physical
therapist or occupational therapist could help.

Steve
Ann - 25 Sep 2006 16:27 GMT
>> I really don't know. What I end up doing is brushing one quadrant, take
>> a break, go back and do more, etc. It seems like I have the most trouble
[quoted text clipped - 6 lines]
>can see where the difficulty is.  I'm inclined to think a physical
>therapist or occupational therapist could help.

I think so too.  In the UK a physio or occupational therapist would
come up with a solution.  It may be that a brush with a larger handle
or some other adaptation would help but nobody can really know without
seeing the problem.

Ann
rppj - 27 Sep 2006 02:55 GMT
How about resting your elbows on the counter (while you sit on the toilet or
a stool) if your elbows are supported perhaps the tremor will be controlled.

>>> I really don't know. What I end up doing is brushing one quadrant, take
>>> a break, go back and do more, etc. It seems like I have the most trouble
[quoted text clipped - 13 lines]
>
> Ann
David Moran - 27 Sep 2006 03:02 GMT
> How about resting your elbows on the counter (while you sit on the toilet or
> a stool) if your elbows are supported perhaps the tremor will be controlled.

Tried it, doesn't work  -- Dave

>>>> I really don't know. What I end up doing is brushing one quadrant, take
>>>> a break, go back and do more, etc. It seems like I have the most trouble
[quoted text clipped - 12 lines]
>>
>> Ann
mamounjo3@yahoo.com - 29 Sep 2006 14:39 GMT
What about attaching the toothbrush to the wall, and then brushing your
teeth by bringing your teeth to the toothbrush, instead of the other
way around.  You could have four toothbrushes fixed to a wall or the
edge of a countertop.  One with the bristles facing sideways left, the
other with the bristles facing sideways right, the other with the
bristles facing up and the other with the bristles facing downward.
Put them above the floor at mouth level, and put toothpaste on them.
Then, open your mouth and try to gently move your head towards and away
from the tooth brushes such that the brushes contact the teeth and
brush them.

> > How about resting your elbows on the counter (while you sit on the toilet or
> > a stool) if your elbows are supported perhaps the tremor will be controlled.
>
> Tried it, doesn't work  -- Dave
 
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