Manual toothbrushing can be difficult for certain patients, with manipulating the brush effectively and reaching the accessible tooth surfaces proving challenging, leading to inadequate cleaning results. Similarly, manually brushing too fiercely can cause gingival trauma and bleeding, whilst the extra exertive pressure can wear the tooth tissue down.[i]
Limitations in dexterity can therefore lead to an increased risk of oral diseases, as toothbrushing is unable to remove the trapped food debris and harmful bacteria. One complication to note is carpal tunnel syndrome (CTS), a condition whose impact extends beyond toothbrushing and into a patient’s overall quality of life. Dental practitioners should identify the risk factors for CTS to patients, ensuring that the preventative measures are taken to maintain optimal manual dexterity.
Tunnel vision
CTS has an incidence of 7-16% in the UK, making it one of the most common compressive neuropathies.[ii] A carpal tunnel is the formation of a deep arch anteriorly in the wrist, next to the carpal bones and retinaculum. This compresses the median nerve as it passes into the hand, leading to numbness, tingling and pain in the thumb and first three fingers.[iii] Left unchecked, CTS can manifest as a burning that travels up the arm, wrist pain at night that interrupts sleep, and an overall weakness in the hand muscles[iv] – these can inhibit work, reduce productivity, and increase the risk of depression.[v]
Women are three times as likely to develop CTS compared to men, with a common diagnosis bracket being the 30–60-year-old range.iv This is due to hormonal differences; changes during pregnancy or the menopause can cause more fluid to build-up, narrowing the carpal tunnel and intensifying CTS symptoms. Furthermore, a mastectomy can lead to lymphedema, a condition that inhibits fluid drainage and leads to further swelling.[vi] These conditions should be considered when patients presenting with these risk factors have a check-up.
Understanding the underliers
For both men and women, there are a variety of underlying health complications that put patients at risk of CTS. Patients with type 1 and type 2 diabetes may frequently encounter CTS, though the exact connection is unclear.[vii] This can make it difficult for dental practitioners and at-risk patients to prevent the likelihood of CTS developing. Thyroid disorders, kidney failure, high blood pressure and rheumatoid arthritis are other conditions that can increase CTS prevalence – monitoring affected patients is essential.iii
Hands-on jobs
Lifestyle habits like smoking and a sedentary lifestyle are also connected to CTS, but job type can be a crucial signpost.iv Patients who work in manufacturing, construction and computer-related roles are likely to have repetitive hand motions that can make CTS more noticeable. Dental practitioners too may find that complex procedures that require a firm grasp, fine tactile movements, prolonged static pauses and repeated motions may cause similar pain and tenderness in the hand and wrist and should take measures to rest where possible.[viii]
Patients whose lifestyle choices put them at-risk of CTS should be asked if they experience any pain or tenderness in their wrist, hands and fingers, especially when toothbrushing. For those that do, there are various options to manage the condition. Depending on the severity, this includes avoiding positions that overextend the wrist, taking mild pain medication, wrist splints, steroid injections and treatment of underlying conditions, all of which should make daily manual tasks easier and more comfortable.iv
Get electric
An electric toothbrush is an effective alternative to the traditional manual toothbrush for CTS patients; the excellent oral hygiene results are supported by the simple function of the device, with the brush doing the hard work instead of the hand. For patients with mobility issues, using an electric toothbrush ensures that each tooth is cleaned without causing pain or discomfort in the hand and wrist.[ix]
The Hydrosonic Pro, from Curaprox, is an innovative and invaluable asset to the daily oral hygiene routine. From its sleek appearance and ergonomic handle to its 7 cleaning settings and angled brush heads, everything about the first-class electric toothbrush is designed to improve compliancy and produce exceptional results in removing plaque and food debris. Presented with three brush heads – power, sensitive and single – patients can personalise their daily dental care to accommodate any mobility complications in the hands and wrists for the most comfortable clean possible.
CTS can have a major impact on a patient’s quality of life, inhibiting basic tasks and leading to a decline in oral health if toothbrushing isn’t effectively done. Identifying the vulnerable patients and guiding them towards the best management techniques ensures that they are sufficiently protected from oral disease.
To arrange a Practice Educational Meeting with your Curaden Development Manager please email us on sales@curaden.co.uk
For more information, please visit www.curaprox.co.uk and www.curaden.co.uk
Andrew Turner Curaden UK Head of Marketing UK & Ireland
[i] Thurston, Mark. (2015). Oral Health for Adults with Dyspraxia v1.01. Accessed via: https://www.researchgate.net/publication/327449563_Oral_Health_for_Adults_with_Dyspraxia_v101
[ii] Chong, H.H., See, A. and Kulkarni, K. (2024). National trends in the initial diagnosis and management of carpal tunnel syndrome: results from the ELECTS (ELEctrophysiology in Carpal Tunnel Syndrome) study. Annals of The Royal College of Surgeons of England, 106(1), pp.64–69. doi:https://doi.org/10.1308/rcsann.2022.0087.
[iii] NHS (2021). Carpal tunnel syndrome. [online] NHS. Available at: https://www.nhs.uk/conditions/Carpal-tunnel-syndrome/.
[iv] Healthline. (2015). Carpal Tunnel: Causes, Symptoms, and Diagnosis. [online] Available at: https://www.healthline.com/health/carpal-tunnel-syndrome#prevention.
[v] Alsharif, A., Al Habbal, A., Daaboul, Y., Al Hawat, L., Al Habbal, O. and Kakaje, A. (2022). Is psychological distress associated with carpal tunnel syndrome symptoms and nerve conduction study findings? A case–control study from Syria. Brain and Behavior, [online] 12(2). doi:https://doi.org/10.1002/brb3.2493.
[vi] Abichandani, S., Shaikh, S. and Nadiger, R. (2013). Carpal tunnel syndrome – an occupational hazard facing dentistry. International Dental Journal, [online] 63(5), pp.230–236. doi:https://doi.org/10.1111/idj.12037.
[vii] Zimmerman, M., Gottsäter, A. and Dahlin, L.B. (2022). Carpal Tunnel Syndrome and Diabetes—A Comprehensive Review. Journal of Clinical Medicine, [online] 11(6), p.1674. doi:https://doi.org/10.3390/jcm11061674.
[viii] Deepika Chenna, Madi, M., Kumar, M., Kumar, V.S., Sitaram Chopperla, Abhinav Tadikonda and Kalyana Chakravarthy Pentapati (2023). Worldwide prevalence of carpal tunnel syndrome among dental health care personnel – A systematic review and meta-analysis. F1000Research, [online] 12, pp.251–251. doi:https://doi.org/10.12688/f1000research.131659.2.
[ix] Healthline. (2018). Electric Toothbrush vs. Manual Toothbrush: Which Is Better? [online] Available at: https://www.healthline.com/health/dental-and-oral-health/electric-toothbrush-vs-manual#takeaway.
