Dental care — brush up on the basics.

The basics.

You’ve been told it’s good to have healthy teeth. That’s because a healthy smile is part of a healthier you. Good oral health means having clean and healthy teeth and gums. And healthy teeth and gums can help prevent common dental problems like:

• Cavities (holes in the outer layer of your teeth)
• Gum disease (infection of the gums)

Did you know good oral health is extra important for people with sickle cell disease? Having sickle cell disease doesn’t mean you’re more likely to have dental problems, but it does mean these problems may be harder to treat. Gum disease and dental work to treat problems may cause bleeding. And if untreated, you could bleed more or longer.

The good news is there are ways to keep your teeth and gums healthy. Use these tips to help prevent dental problems.

Find a dentist.

A healthy mouth starts with finding the right dentist. Look for one who knows or is willing to learn about sickle cell disease and create a treatment plan for you. Then make sure your dentist works with your hematologist to:

• Create a treatment plan that is right for you
• Make sure any work or procedures you need are done safely
• Help your dentist understand how best to manage pain and lessen the possibility of infection

If you need help finding a dentist, call your hematologist or hemophilia treatment center (HTC). They can help you find a dentist in your area who knows how to care for people with sickle cell disease. They may also have a specific group of dentists to refer to you.

Prepare for dental work.

Before you have any dental work or procedures, talk with your hematologist and dentist to create a treatment plan together. Follow the checklist below before each dental visit.

• Remind your dentist of your diagnosis of sickle cell disease
• Give your dentist the name and phone number of your hematologist
• Let your dentist know: 
  • about your treatment plan and what medications you are taking
  • what a typical crisis may look like for you
  • what methods you use for pain management
  • if you have other medical conditions
  • if you need antibiotics as a pretreatment
  • if you have a port
  • any complications you have had with previous dental work

Practice good oral care.

Many dental problems are caused by the build-up of plaque in your mouth. Plaque is a sticky film on your teeth that’s made when bacteria mix with food. Plaque build-up can weaken your teeth and gums.

Good oral care removes plaque to help prevent some dental problems, like cavities and gum disease. What does good oral care mean? It means:

• Brushing your teeth at least twice a day with fluoride toothpaste. Use a soft, rounded toothbrush to protect your gums. Check your toothpaste label to make sure fluoride is listed as an ingredient.
• Flossing your teeth after brushing to remove any remaining plaque

You may think that brushing and flossing will make your gums bleed. But healthy gums don’t usually bleed from brushing and flossing. Your gums may bleed for a bit when you start flossing. With regular flossing, the bleeding will usually stop. So keep brushing and flossing for your healthiest gums. And remember, a soft, rounded toothbrush is gentler on your smile.

Call your hematologist if your gums bleed non-stop for more than 20 minutes or stop bleeding and then start again. Talk to your hematologist or dentist if you have any questions about brushing or flossing.

Care for mouth bleeds.

Take good care of your mouth. Falls and injuries to your entire mouth (gums, tongue, cheeks and lips) can cause bleeding.

Follow this tip to stop mouth bleeds:

• Press down firmly on the bleeding area with a clean gauze, cloth or moist tea bag

Call your hematologist if a mouth bleed lasts for more than 20 minutes. Your doctor may prescribe a medication to help stop the bleeding and help heal your mouth.

Some mouth bleeds can block your airway. This is a medical emergency. Call your hematologist and get medical help right away if you have:

• Bleeding on the tongue, cheek or bottom of the mouth that doesn’t stop
• Any swelling or bruising of the tongue, throat or neck
• You’re having trouble breathing or swallowing

Help avoid mouth bleeds by following these safety tips:

• Always wear mouth guards when you’re playing sports
• Wear mouth guards and night guards to avoid chipped teeth and cut lips, especially if you wear braces
• Don’t get your lip or tongue pierced

Keep a healthy smile.

A healthy smile means fewer mouth bleeds and less need for major dental work. Follow these tips to help prevent dental problems:

• Practice good oral care. Stay on track with brushing and flossing twice a day.
• Visit your dentist regularly. Have your teeth cleaned at least twice a year. Talk to your dentist about how often to schedule your visits.
• Limit foods and drinks with sugar. Sugar from your food and drinks helps plaque grow.
• Get enough fluoride. Fluoride helps strengthen your teeth and prevents cavities. Ask your dentist if you need a fluoride supplement too.
• Quit smoking and avoid using tobacco. Smoking or chewing tobacco can lead to gum disease and mouth cancer. If you smoke, talk to you doctor about ways to stop smoking. 

For additional support, talk to your health care provider or call the CVS Specialty Sickle Cell Disease CareTeam at 1-844-641-0413.