The person needs to see a dentist as soon as possible. Hard deposits cannot be removed by brushing, only by special scaling instruments. Dental hygienists are trained to provide this treatment and give practical advice. Regular and effective tooth-brushing is the most effective method of controlling the disease and damage caused by plaque. It suggests that people who are dependent on others for their oral hygiene, are disadvantaged by poor standards of daily oral hygiene.
Oral hygiene is part of personal care and support for the activities of daily living.
Inadequate oral hygiene leads to periodontal disease and ultimately tooth loss. For more profoundly disabled people this presents an additional challenge for staff and carers as poor oral hygiene increases the risks associated with a general anaesthetic provided to relieve pain and discomfort. Tooth-brushing can present ethical challenges when children and adults resist or refuse this aspect of personal care. They may be distressed or show resistance to having their teeth brushed because their gums are sore. Yet the most effective cure is to improve standards of brushing.