Polio and Oral Health

Polio or infantile paralysis is a contagious viral infection that causes inflammation of the spinal cord’s grey matter and damage to the motor neurons (the nerves controlling the muscles of movement). The disease can cause paralysis and even death. 

In Australia, between the 1930s and 1960s, 40,000 cases of paralytic poliomyelitis were recorded. However, many more people (up to 4 million) were either not diagnosed or did not experience the paralytic symptoms of the infection. Up to 40% of previously stable survivors of polio are now experiencing the late effects of polio, a condition known as Post-Polio Syndrome, or PPS.

The symptoms of PPS include:

  • fatigue (from minimal physical activity)
  • decreased strength and endurance
  • muscle and joint pain
  • spasms and twitching
  • struggling to stay alert and concentrate
  • difficulties speaking and swallowing, and
  • cold/heat intolerance

Health practitioners are realising that they need to become adept at recognising the symptoms of PPS and helping people to manage them in their daily lives.

How Polio Affects Oral Health

The following are ways that Polio can impact on one’s oral wellbeing:

  • Polio may affect a patient’s ability to eat 
  • Problems with swallowing can influence an individual’s food choices, often causing them to choose foods that increase the likelihood of developing dental disease.
  • Muscle weakness and fatigue can affect a person’s ability to clean their teeth thoroughly.
  • Polio can affect an individual’s response to dental anaesthesia and treatments. 

Dental Appointments for Polio Survivors

The dental care of people with PPS often requires that some modifications be made during the appointment. These are modifications that our dental team are happy to make because the comfort and well-being of patients is our focus. Polio Survivors should never be hesitant in explaining their condition and requesting that their individual needs to be met.

Modifications to Dental Appointments

Considerations for dental appointments may include:

  • Scheduling appointments early in the day
  • Agreeing upon hand signals that allow clear communication during the appointment
  • Taking breaks during the appointment to minimise patient fatigue
  • Placing the dental chair in a more upright position than usual, to make it easier for the patient to breathe and swallow
  • Provision of additional support for the neck and/or back
  • Provision of blankets or cooling to counter temperature intolerances
  • Providing anything else that improves the comfort and confidence of the patient during the appointment

How Polio Survivors Respond to Local Anaesthetics

It is important that the dental team be aware of the unique responses Polio Survivors may have to local anaesthetics. 

  • They may need twice the typical dose, and recovery can take twice as long
  • Any numbness affecting the throat or tongue may have an impact on swallowing; the dental team will need to be vigilant about providing good suction and opportunities “to have a breather.”

The presence of a friend or family member at the appointment may provide support and assistance both during and after the appointment.

Please do not allow PPS to stop you from receiving the dental care you need. Make contact with your dental team, communicate your needs with them and be sure that you have scheduled some time and support after your appointment for recovery.

If your health practitioners need more information about PPS, they can find it in the clinical information section of the Polio Australia website.

Daily Dental Care for Polio Survivors

Polio Survivors can find it challenging to look after their teeth and gums, putting them more at risk of developing dental diseases such as tooth decay and gum disease.

  • Muscle weakness and pain, and general fatigue can make it challenging to clean the teeth thoroughly on a regular basis. 
  • Changes to the diet may be necessary to manage difficulty in swallowing. If care is not taken to minimise sugary or acidic foods, tooth decay is likely to occur.

By being aware of these risks, Polio Survivors can make some simple modifications to their daily routine that will allow them to maintain good oral health.

Brushing and Flossing

It is important to clean the teeth on a twice-daily basis thoroughly. This generally requires brushing as well as cleaning between the teeth. The latter is typically achieved using floss, although there are other options available.

Polio Survivors who experience muscle and joint weakness or pain in their arms or hands may find it helpful to use an electric toothbrush instead of a manual one. 

  • The handle of an electric toothbrush is thicker, making it easier to grip. 
  • Its oscillating head does most of the work in cleaning the teeth. 

A wall-mounted toothpaste dispenser may also be helpful.

Focus on Nutrition

Foods and beverages that are unhealthy tend also to be harmful to teeth. Try to reduce snacking on lollies, chips, chocolates, biscuits, cakes and even muesli bars. Beware of hidden sugars in foods and drinks.

If you have needed to modify your diet to accommodate difficulty with swallowing, be mindful of the quantity and frequency of sugars that you are consuming. Many soft, easier-to-swallow foods are sweet (such as custards, jellies, and ice cream) and added sugars are surprisingly common ingredients of packaged foods. So plan your modified diet to ensure you are not constantly consuming sugars and that you are receiving all the nutrients you need for general health.

We’re Here to Help

If you are living with PPS, please keep us informed of your progress so that we can ensure you enjoy the best possible dental health now and in the future. Dr Teo is happy to answer any of your questions about the effects of polio on your dental health. She will also make any modifications necessary to ensure your visits with us are as comfortable as possible.