Oral care and the role Pharmacy plays

By Sherree Walters Cert IV TAE, Cert IV Community Pharmacy

Workplace Trainer/Assessor

Oral care and pharmacy role
Don’t forget that tongue health is also important


As children our parents constantly remind us of the importance of looking after and brushing our teeth. “Clean teeth create happy smiles” my Mum used to tell me as she would stand at the door of our bathroom every morning and night supervising my brother and I with the ritual of following the oral care routine she had instilled on us. As we got older and entered our teenager years, we became complacent with our oral care routine, as did my Mum’s watchful eye and regular reminders.

In my teenage years I recall having a fascination with braces and desperately wanting to need them. I was very disheartened when I was told by my dentist that I did not need them as my teeth were lovely and straight. I found this so frustrating, not realising how absolutely lucky I was for not needing them. I was able to eat hard and toffee like foods that someone wearing braces could only dream of. All through my teenage years I ate food and consumed gallons of soft drink laden with sugar and brushed my teeth when I felt like it, maybe this was my way of refusing to conform to societies values. Little did I know, it was not a smart move.

As the years wore on and I ventured into my adult years, I started to realise how right my Mum was with her words of oral care wisdom, why did I have to be such a rebel without a cause, especially when it came to dental care and oral hygiene.

Before we can talk to our customers in regards to oral hygiene routines and how they can best protect their teeth, we need to have a bit of understanding in regards to the purpose of teeth.

(Rideaudental.ca) We have four different types of teeth, Incisors, Canines, Premolars and Molars The incisors are the first eight teeth in the front centre, top and bottom of the mouth and these are the teeth that are used to cut the food that we consume. Canines are next. These stab the food allowing it to be broken down to smaller particles. Premolars- these are the teeth that are used to tear and crush food even further. Molars, the largest of all the teeth are situated at the back of the mouth. These are there to chew, crush and grind food before swallowing. (Ashvilledentalcare.com) The reason we need teeth is to ensure we are able to easily chew and swallow food in order to digest food properly.

Teeth are the hardest structure in the human body but can easily be damaged if we do not look after them. Bacteria in our mouths produce acids which attack the teeth and cause holes in our teeth which are commonly referred to as cavities. Plaque, which attaches to the teeth and gums can also cause gingivitis which is basically gum disease. This results in the gums appearing red, swollen and sore.

Without healthy gums, how are we supposed to hold our teeth in place?

As pharmacy assistants, we see many different products entering the market and sometimes it can be confusing to know what the right product will be for our customers. If we follow the below simple steps we can determine the needs of the customer and provide them with a whole oral care solution for their needs.

When I am speaking to my customer about their oral care needs and wants, I always refer back to my What, Stop, Go protocols to help guide me with an understanding and to also assist me with providing for my customer to the best of my ability.

Firstly, who is requiring the product? Is it a child, an adult, a person with dentures? There are products available for different needs and age groups, for example, some fluoride containing toothpastes may be too strong for children to use., A normal everyday toothpaste for an adult contains  between 1350ppm( parts per million ) and 1500ppm. A child under 3 years’ of age requires less, approximately 1000ppm. Children tend to swallow instead of spit when brushing their teeth which is why we have products such as Colgate Milky teeth and Oral B stages. Older people with dentures also need to be careful when selecting a toothpaste as everyday toothpastes can damage dentures. It is recommended that people with dentures use a soft toothbrush, specifically a denture brush and water only when cleaning dentures and must take care not to damage any of the attachments that are used to hold the denture in the mouth. (oralb.com)

Ask the customer next what they are wanting from the toothpaste and what they have used in the past? Was it effective? Do they want it to just clean? Do they have sensitive teeth? Are they wanting to whiten and brighten their teeth? Or are they after a natural toothpaste? This will help with the selection process for the right toothpaste. Many companies have different brands that cover different needs and wants. By asking these questions we can select the right toothpaste for the needs of the customer, whether this be from our Colgate, Oral B or Sensodyne brands.

Do we think it’s important to ask the customer if there are any symptoms that need to be addressed? Of course we do. They may have gum disease, gingivitis, cavities or caries in the teeth. This again will help us determine the correct toothpaste, gargle or rinse required and or refer on to the pharmacist for more specific specialist advice.

Do you have any other health conditions or take any other medications? If they answer YES, we know we must refer this on to the pharmacist.  This is really important as conditions such as cancer, anaemia, HIV/AIDS, diabetes, high blood pressure, depression and allergies can all affect the choice in oral care products we select. Many of the above medical conditions and medications used to treat them can result in placing people in higher risk categories for other oral conditions such as inflamed or bleeding gums, gum disease, oral thrush, dry mouth and tooth decay. (oralhealth.deltadental.com) Always remember these are important questions and without them we may not be able to select the correct oral health care regime for our customers.

Apart from just brushing teeth with toothpaste, we need to provide a whole health care routine for our customers which includes brushing, rinsing and flossing. Based on the above questions, we can identify our customers additional needs such as which mouthwash they can use to assist with the condition, can they can use floss or are piksters necessary to clean in between the teeth and gums. Would they benefit from additional products like whitening kits that will aid in restoring the white appearance of the teeth and do they require an oral breathe spray?

Lifestyle tips for customers to follow are also an important part of our job. This helps the customer to understand and take measures to maintain their teeth.

+ Always remember to brush twice a day

+ Don’t forget that tongue health is also important and always brush the tongue. When selecting a toothbrush for your customer ensure it has a tongue cleaning feature

+ Use a fluoride toothpaste that is best for the persons needs

+ Use a mouthwash and floss to help maintain oral health and healthy gums as a follow up to brushing the teeth

+ Stay hydrated, drink more water and try to avoid excess sugar drinks, caffeine and juices

+ Maintain a healthy diet

+ Most importantly, remind your customers to visit the dentist twice a year

By following the above points you are well on your way to assisting your customers with their oral care health and management for strong healthy teeth and gums.

Like my Mum said – clean teeth create happy smiles, and who doesn’t want a happy smile?