www.healthinfo.org.nz Oral hygiene & saliva management

Oral hygiene means keeping your mouth (teeth, tongue, gums, and roof of your mouth) clean and healthy. Your mouth should be pink and moist. Good oral hygiene maintains healthy teeth and limits the growth of bacteria in your mouth. Oral hygiene is important for everyone, particularly people who have swallowing difficulties. It is very important for people who cannot eat and drink (nil by mouth, or NBM). The bacteria in your saliva, food, and liquids can go into your airway. This is called aspiration. This may increase the risk of lung infection. Illness or medication can affect the cells that line your mouth and cause unpleasant side effects such as changes in taste, sore or bleeding gums, dry mouth, oral thrush, redness, swelling, and ulcers. Taking good care of your mouth will help to stop this from happening. Changes in saliva

You may have a dry mouth, or excess saliva. It can be runny, or thick and stringy. You may find it difficult to swallow your saliva. This can lead to drooling, especially if your facial muscles are weak. Keeping my mouth clean

▪ Brush your teeth at least twice a day with a soft toothbrush and toothpaste containing fluoride. ▪ Brush your gums and tongue. ▪ After brushing, swish and spit the toothpaste out but don’t rinse. ▪ Make sure there's no food left in your mouth after meals. Check in your cheeks, your teeth, under your dentures, and on your tongue. You may need to do this after every meal. ▪ Try to avoid drinks and food containing sugar between meals.

HealthInfo reference: 78460 ⚫ Issued: 21 October 2020 ⚫ Page 1 of 3

Oral hygiene & saliva management www.healthinfo.org.nz If you have dentures (false teeth)

▪ Brush your dentures with soap and water after each meal. Leave your dentures out of your mouth at night. Soak them in a denture cleaner such as Polident or Steradent. ▪ Take your dentures out if you are applying a cream or gel in your mouth. ▪ If you have a mouth infection it's important to soak your dentures at night, otherwise the infection can remain on your dentures. You can use chlorhexidine mouthwash to clean dentures, or try soaking them in quarter-strength Milton antibacterial solution. You can buy these at your pharmacy. How to help a dry mouth

▪ Regularly sip water or other cool drinks. ▪ Reduce alcohol, caffeine, and smoking. ▪ Use a saliva replacement. Talk to a pharmacist about mouth moisturisers or lubricants and other dry mouth products. ▪ Use salt and baking soda mouthwash after every meal, or as you need it. Make it with ½ teaspoon of salt and ½ teaspoon of baking soda dissolved in 200 ml water. Make it fresh every day and keep it in the fridge. ▪ Chew sugar-free gum. ▪ Suck ice cubes or crushed ice. ▪ Keep you lips moist with petroleum jelly (Vaseline) or lip salves.

Note: If you're using thickened fluids some of these tips are not appropriate – talk to your speech-language therapist before trying them. How to help with thick saliva

▪ Drink more. ▪ Try a steamy shower, or steam inhalation. ▪ Sip soda water. This can be thickened if necessary. How to reduce excess saliva

▪ Frequent dry swallows. ▪ Regular sips of liquid.

Medical treatments are also available to help with saliva changes – talk to your doctor about the options.

HealthInfo reference: 78460 ⚫ Issued: 21 October 2020 ⚫ Page 2 of 3

Oral hygiene & saliva management www.healthinfo.org.nz Ways to moisten your mouth Talk to your dentist, pharmacist or radiation team about a mouthwash that will be suitable. Chewing gum Chew sugar-free chewing gum, preferably containing xylitol. You can get this from a supermarket or chemist. Moistener, lubricating gel, or artificial saliva Talk to your dentist or pharmacist about using oral lubricants such as GC Dry Mouth Gel or Biotene Oral Balance. Try coconut oil. Other remedies ▪ Add one drop of peppermint essence to 100 ml of grapeseed oil, and apply a drop or two to your mouth when it starts to get dry. ▪ Suck crushed ice. You should also talk to your dentist about how to protect your teeth from the dental decay that often happens when you have a dry mouth.

Written by speech-language therapists, Canterbury DHB. Adapted by HealthInfo clinical advisers. Last reviewed October 2020.

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HealthInfo reference: 78460 ⚫ Issued: 21 October 2020 ⚫ Page 3 of 3