Wednesday, February 17, 2016

22 Ways to Clear Pocking Without Using A Toothette Brush

The Trouble With Toothettes

Toothette Oral Swabs, or as I call them, Toothette brushes, are an important part of daily patient care in facilities from coast to coast. Easy to come by, Toothettes can be found all over the place: in central supply departments, nurses' stations, bedside tables, bathrooms, therapy gyms, rehab offices and on top of nightstands. 

I keep a bunch of them stashed in my desk drawer, I almost always have one in my pocket, and it wouldn't be unusual to find a Toothette in my purse. Abundantly available, I grab these brushes by the handful and pass them out to my patients up and down the halls.  

I think I'm being clear... there's no shortage of Toothette brushes in healthcare facilities.

In case you've never used a Toothette, they're just a little pink sponge on a stick. The thing that makes them extra special is a light coating of a pleasant, minty dentifrice.  (Now there's a word you don't use very often!)

These swabs are perfect for moistening a chronically dry mouth, they're good for scrubbing teeth and most importantly, they can gently remove tiny little food particles from hard to reach places in the back corners of the mouth. With such great versatility, you just have to love the Toothette swab.

With that in mind, fast forward to....

Today, I overheard a phone conversation between my patient's wife and her insurance company. They were discussing Toothettes.  I only heard half of the conversation, of course (because she was on the phone), but I'm pretty sure I know what the insurance company representative was saying. 

Here's what I actually heard and what I imagined was being said:

     You won't pay for them?
     No, we won't pay for them.

     It's medical equipment my husband needs.
     Uh huh, but we won't pay for them.

     What if I call the doctor and get a prescription?
     It won't matter, because we won't pay for them.

     He had a stroke and he pockets food in his mouth.
     Yes, but we don't pay for them.

     It's so important to keep his mouth clean. 
     Right, but we don't pay for them.

     What am I supposed to do?
      You'll have to pay for them yourself.

     Those things are really expensive.
     Uh huh, that's why we don't pay for them.

     I guess I'll have to ask the speech therapist what to do.
     Yeah, because... we won't pay for them.

She hung up the phone and immediately called my name. Looking like she was ready to pull out her hair, she asked:

     Can you believe my insurance company won't pay for those pink sponges?
     Yes, I can believe it. Insurance usually doesn't pay for Toothette brushes. 
     Once you're home, a Toothette is a luxury item.

     Those little things are hard to find and when you do, they are expensive.
     What am I supposed to do? 

Oh boy, I love it when people ask me that question! 

I did some super sonic brainstorming as I sat at her kitchen table and came up with a list of suggestions on how to handle oral pocketing when your supply of Toothettes is scarce. 

How To Clear Pocketing:
22 Toothette Alternatives

 Before Eating

  1. eat softer foods
  2. add extra gravy or sauces to meats and veggies
  3. chop meats, fruits and veggies into small/ smaller pieces
  4. make sure veggies are tender cooked
  5. adjust seating
  6. position head and body to midline

While Eating

  1. take smaller bites
  2. chew thoroughly
  3. use a liquid wash
  4. perform a lingual sweep
  5. alternate solids and liquids
  6. aim utensil to the strong side of mouth/ away from the weak side of mouth
  7. chew on the stronger side
  8. reduce the rate of intake
  9. adjust seating as needed
  10. maintain head and body at midline position

After Eating
  1. use a gloved finger (yours or theirs) to sweep out particles
  2. use an infant finger brush to gently remove foods
  3. use a soft, small head toothbrush (infant, toddler or adult) to pull out particles 
  4. swish and spit using water or mouthwash

Improve Oral Motor Function
  1. perform therapeutic cheek exercises to increase strength and range of motion 
  2. perform therapeutic lingual exercises to increase strength and range of motion

I'm a speech pathologist first but I'm also a darn good creative problem solver.  As a result, this family has 22 effective ways to resolve oral pocketing without spending a penny. Give that SLP some bonus points!

This isn't an all inclusive list, but I hope it reminds you that we have lots of options when it comes to alleviating oral pocketing. Please comment below if you know of any other methods not mentioned above. 

By the way, a few of these terms are considered professional jargon, so if you're not sure what, when, why or how, be sure to consult a speech pathologist for additional information. 

Be true to your teeth or they will be false to you.
Soupy Sales