Some effects of a stroke, such as arm weakness, swallowing difficulties or cognitive problems, can make it harder to look after your teeth and mouth. You should have help and support if you need it to look after your mouth and teeth. Good oral hygiene (mouth care) can help you to stay healthy by reducing the germs in your mouth.

Oral and dental problems may be more common after a stroke. They may include:

• Complications due to swallowing problems: keeping your mouth and teeth clean can help reduce the risk of serious complications, such as lung infections (pneumonia), which can occur when bacteria from the mouth are breathed into the lungs. Learn more about all aspects of swallowing problems and how to dealSwallowing problems with them.
• Changes to taste: a fungal infection (thrush) can lead to a bad taste in your mouth, which can put you off eating. Learn more about all aspects of taste and smell changes after stroke and what causes them.
• Tooth decay and gum infections: these can make your mouth sore and make it harder to eat and drink. Regular cleaning will reduce the chance of gum infections or tooth decay.
• Difficulty wearing dentures: Changes to the muscles in your mouth, or having a dry mouth, can make it harder to wear dentures after a stroke.

If you have swallowing problems, ask your stroke nurse or speech and language therapist for individual advice about how to keep your mouth and teeth clean.

Tips for good oral hygiene after stroke

• Brush after meals if possible – Ideally, clean your teeth and dentures after every meal. If that’s not possible, aim for at least twice a day, for about two minutes each time, including before bedtime. Make sure you clean all the surfaces thoroughly.
• Use fluoride toothpaste – To clean your teeth, use a pea-sized amount of toothpaste with high fluoride levels (at least 1350ppm or 1450ppm fluoride).Non-foaming toothpastes (sodium lauryl sulphate-free) may be easier to use if you have swallowing problems and help reduce the risk of aspiration.
• Clean your mouth and tongue too – Use a soft toothbrush and toothpaste to gently clean your tongue and the inside of your mouth.
• If your brush is hard to hold – An occupational therapist can advise on adaptations if you struggle to grip your toothbrush.
• After brushing - Spit out any excess toothpaste if you can. You do not need to rinse out your mouth after you have finished brushing your teeth. This helps keep fluoride from the toothpaste on your teeth for extra protection.
• Look after your dentures – If you have dentures, clean them regularly, take them out at night, and store them in a labelled denture container to keep them safe and stop them getting damaged or lost.
• Limit sugary food and drinks – These can damage teeth. If your dietitian advises you to eat sweet foods, clean your teeth carefully afterwards. Food supplements can also cause decay, so clean your teeth or rinse your mouth with water after taking them.
• Seek help for a dry mouth – If you have a dry mouth due to swallowing problems or medication, ask your GP or speech and language therapist for advice. Even if you cannot drink, you may be able to use saliva sprays or special gels to help with dryness.
• Protect your lips – Use lip balm to stop lips from getting dry or cracked.
• Have regular dental check-ups – Your dentist can help keep your mouth healthy and give you advice. If you cannot travel to the surgery, ask about services that offer home visits.