Oral Care
Looking after your mouth helps protect your health and supports safer swallowing.
Good oral care is an essential part of staying healthy.
Keeping your mouth clean helps prevent tooth decay, gum disease and the build-up of harmful bacteria. For people with swallowing difficulties (dysphagia), maintaining good oral hygiene is particularly important because it can reduce the risk of aspiration pneumonia.
This page explains why oral care matters and provides practical advice for patients, families and carers.
Why is Oral Care Important?
Brushing your teeth and cleaning your mouth every day helps to:
- Keep your teeth, gums and mouth healthy
- Prevent plaque and gum disease
- Reduce harmful bacteria
- Keep your mouth feeling clean and comfortable
- Improve overall oral health
Good oral hygiene benefits everyone, but it is especially important if you have swallowing difficulties
Why is Oral Care Important for People with Swallowing Difficulties?
People with swallowing difficulties may find that food, drink or saliva remains in the mouth after eating.
This can encourage bacteria to grow, which may then be swallowed into the lungs. This is known as aspiration.
Aspiration can sometimes lead to aspiration pneumonia, a serious chest infection.
Good oral care has been shown to reduce the risk of aspiration pneumonia in people with swallowing difficulties.
When Should Oral Care Be Carried Out?
Good oral care should become part of your everyday routine.
We recommend:
- Brushing your teeth at least twice a day (morning and before bed)
- Checking your mouth before and after meals
- Removing any leftover food after eating
- Cleaning your mouth more frequently if you experience a dry mouth or excess saliva
- Cleaning your mouth even if you have no natural teeth or wear dentures
Who Should Carry Out Oral Care?
Whenever possible, people should be encouraged to brush their own teeth.
If someone needs assistance, carers should support them safely and comfortably.
Some people may benefit from:
- Electric toothbrushes
- Toothbrushes with larger handles
- Angled toothbrush heads
- Adaptive hand grips
An Occupational Therapist (OT) can advise if specialist equipment may be helpful.
Choosing the Right Equipment
For most people we recommend:
- A soft or medium-bristled toothbrush with a small head
- A pea-sized amount of toothpaste
- Low-foaming toothpaste where possible
Avoid wetting the toothbrush before brushing as this helps reduce foaming.
How to Support Someone with Oral Care
If you are helping someone brush their teeth:
- Stand or sit behind them where possible.
- Support their head comfortably.
- Tilt their head slightly forwards.
- Brush all tooth surfaces, gums and tongue.
- Remove toothpaste with a damp cloth or toothbrush rather than rinsing with water.
- Leave fluoride toothpaste on the teeth to continue protecting against decay.
If someone is unable to sit upright, raise the head of the bed if possible or position them on their side with their head slightly forward.
People without natural teeth should still have their gums gently brushed with a soft toothbrush.
Where available, suction equipment may sometimes be used to reduce the risk of aspiration.
Oral Care for People Who Are Nil by Mouth
People who are unable to eat or drink still need regular mouth care.
Without regular brushing:
- Plaque can build up quickly.
- The mouth may become uncomfortable.
- Dry mouth is common.
- Some people may become sensitive to oral care.
Gentle brushing with a soft toothbrush and mild toothpaste can help maintain comfort and oral health.
Managing a Dry Mouth
A dry mouth is common in people with neurological conditions and swallowing difficulties.
It can:
- Increase the risk of tooth decay
- Increase the risk of gum disease
- Make chewing and swallowing more difficult
- Cause discomfort
If appropriate, encourage frequent small sips of water.
Saliva replacement gels or sprays, such as BioXtra or Biotene, may also help. Speak to your healthcare professional for advice if symptoms continue.
Looking After Dentures
Dentures should be cared for just like natural teeth.
You should:
- Rinse dentures after meals.
- Brush them twice a day using a denture brush or soft toothbrush.
- Use warm soapy water or a denture cleaning product.
- Store dentures in cold water when not being worn.
- Remove dentures overnight.
Keeping dentures clean helps maintain good oral health and comfort.
Further Training
Additional mouth care training is available through the Mouth Care Matters e-learning programme for healthcare professionals and carers.
Further Information
If you have concerns about oral care or swallowing difficulties, please speak to your Speech and Language Therapist or healthcare professional.
Looking After Your Mouth
Maintaining good oral hygiene is an important part of managing swallowing difficulties.
Keeping your mouth clean helps reduce bacteria and may lower the risk of chest infections caused by aspiration.
To maintain good oral health:
- Brush your teeth or clean your mouth at least twice a day.
- Clean your mouth even if you wear dentures or have no natural teeth.
- Consider using SLS-free toothpaste if regular toothpaste produces too much foam.
- Speak to your therapist or GP if you experience a dry mouth.
- Clean your mouth after meals if food tends to collect inside your mouth.
Everyday Tips for Safe Eating and Drinking
These simple tips can help make eating and drinking safer:
- Sit fully upright and stay alert during meals.
- Avoid eating or drinking while lying down.
- Reduce distractions such as televisions or radios.
- Take small bites and small sips.
- Eat slowly and avoid rushing meals.
- Make sure dentures fit comfortably.
- Avoid dry, crumbly or difficult-to-chew foods unless advised otherwise.
- Follow the recommendations provided by your Speech and Language Therapist.
Further Information
If you have concerns about swallowing difficulties or have noticed changes in your eating or drinking, speak to your healthcare professional or contact your local Speech and Language Therapy service.
Specialist Community Neurology Service
Speech and Language Therapy
Bristol, North Somerset and South Gloucestershire
Telephone: 0300 125 5550
Email: sirona.neuro@nhs.net
