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Hello, Mentaldental! Welcome to Wikipedia! Thank you for your contributions. You may benefit from following some of the links below, which will help you get the most out of Wikipedia. If you have any questions you can ask me on my talk page, or place {{helpme}} on your talk page and ask your question there. Please remember to sign your name on talk pages by clicking or by typing four tildes "~~~~"; this will automatically produce your name and the date. If you are already excited about Wikipedia, you might want to consider being "adopted" by a more experienced editor or joining a WikiProject to collaborate with others in creating and improving articles of your interest. Click here for a directory of all the WikiProjects. Finally, please do your best to always fill in the edit summary field when making edits to pages. Happy editing! —k6ka 🍁 (Talk · Contributions) 20:16, 30 January 2016 (UTC)[reply]
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Previous project: Wikipedia:WikiProject_Dentistry/Open_Tasks

Dental articles by quality: [1]

Dentistry stubs: [2] (probably the most useful)

Welcome

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Welcome to Wikipedia and Wikiproject Medicine

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Doc James (talk · contribs · email) 05:52, 2 January 2018 (UTC)[reply]

Here is the content you added

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Please read the above and rewrite it per the recommendations. Best Doc James (talk · contribs · email) 09:21, 16 March 2019 (UTC)[reply]

The first source does not mention dental or teeth? The last source does not mention RA. Doc James (talk · contribs · email) 09:25, 16 March 2019 (UTC)[reply]

Dental Treatment

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Patients suffering from rheumatoid arthritis often experience pain, debilitated motor capacity, lethargy. This impacts on their oral health as it is both challenging and demoralising for patients to adhere to adequate oral hygiene routines.

A multidisciplinary approach can be adopted in order to manage these challenges. Patients may be referred for physiotherapy to:

  • Optimize joint function through exercises eg swimming
  • Receive interim pain relief through transcutaneous electrical nerve stimulators (TENS) and wax baths[1]

Strengthening and stretching hand exercises may be customized to suit individual patients’ needs.[1]

Patients may be referred to occupational therapy to optimize functional abilities via:

  • Managing pain/swelling
  • Building hand strength
  • Splints for resting, or to support work
  • Joint protection techniques

To improve oral hygiene routines,

  • Toothbrush with a larger handle can be adopted to allow easier handling of the toothbrush. The toothbrush handle can be made larger through wrapping rubber bands around the handle, or using racket tape. The dentist can also help with putting additional material around the handle of the toothbrush to allow a tailored grip.[2] TePe Extra Grip is an example of a toothbrush with large handles to aid brushing.
  • Electric toothbrushes may be helpful as less movement is required to brush effectively compared to a manual toothbrush.[3]
  • If fatigue is often experienced while brushing, it may be useful for patients to rest their elbows against a stable surface to support their hands. Patients may consider toothbrushing with alternate hands as a rest as well.[4]
  • Toothpaste dispenser may also be helpful instead of manual squeezing of the tube.
  • For cleaning in between your teeth, using a floss pick or interdental brushes with longer larger handles are easier to use eg TePe Angle, Wisdom Proflex interdental brushes, compared to traditional floss.
  • Many developments have been made to allow ease of cleaning in between teeth as well such as air floss or water floss.

If brushing still poses as a difficulty, oral hygiene may still be maintained by using antiseptic, alcohol-free, fluoride containing mouthwash as well.

To make dental appointments more manageable for patients, patients are encouraged to move their jaws from time to time, to refrain from having their jaw open for too long.[5]

Patients with TMD may be referred for physiotherapy for jaw exercises, are advised to use warm compress against joint area to alleviate pain, jaw rest and adopt a soft diet. Dentists may provide soft splints to be worn at night to aid with discomfort from TMJs.[5][6] Habits such as nail or pen biting, crunching on ice, should be avoided.

Patients with RA may suffer from cervical spine conditions which render their neck unstable. Dentists are to take necessary precautions to ensure that patients with RA always have their head and neck well-supported.

  • Measures can be adopted by using neck lumbar pillows adopted for dental chairs, or ensuring that patient is never laid too far flat in the dental chair.
  • Allow for patients to reposition their head/neck themselves instead of rotate them yourself
  • Dentists can tailor dental appointments at a time most suitable for patients depending on the patient's’ condition eg midday appointments can be made instead if patient finds stiffness most prevalent in the morning.[5]
  • Dental appointments can be kept shorter but more frequent as patients may not tolerate being in the dental chair for a long period due to neck or jaw pain.

References

  1. ^ a b NICE Guidelines [NG100], Rheumatoid Arthritis in adults: management. July 2018. https://www.nice.org.uk/guidance/ng100
  2. ^ Jepson, Nicholas J. A.; Reeson, Michael G. (2002-06-01). "Customizing the size of toothbrush handles for patients with restricted hand and finger movement". Journal of Prosthetic Dentistry. 87 (6): 700. doi:10.1067/mpr.2002.120840. ISSN 0022-3913. PMID 12131899.
  3. ^ Risheim, H.; Kjaerheim, V.; Arneberg, P. (June 1992). "Improvement of oral hygiene in patients with rheumatoid arthritis". Scandinavian Journal of Dental Research. 100 (3): 172–175. ISSN 0029-845X. PMID 1631487.
  4. ^ "National Rheumatoid Arthritis Society Cleaning Advice and Tips". {{cite web}}: Cite has empty unknown parameter: |dead-url= (help)
  5. ^ a b c Galloway, J.; Bansal, R. K.; Souza, S. de (April 2017). "Managing patients with rheumatoid arthritis". BDJ Team. 4 (4): 17064. doi:10.1038/bdjteam.2017.64. ISSN 2054-7617.
  6. ^ Al-Ani, M Ziad; Davies, Stephen J; Gray, Robin JM; Sloan, Philip; Glenny, Anne-Marie (2004-01-26), "Stabilisation splint therapy for temporomandibular pain dysfunction syndrome", in The Cochrane Collaboration (ed.), Cochrane Database of Systematic Reviews, John Wiley & Sons, Ltd, doi:10.1002/14651858.cd002778.pub2
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