Oral

Oral / Denture Care
• Patients confined in bed should receive oral care on a regular basis as part of a personal hygiene routine.
Oral care should be offered before breakfast, after meals and at bed time. It is especially important to
give oral care to patients receiving oxygen, patients with nasogastric tubes in place, those on NPO
(nothing per Orem) and unconscious patients.
Oral care
Includes gargling, tooth brushing and dental flossing.
Purposes:
1. To prevent oral disease and tooth destruction.
2. To promote a feeling of well-being.
3. To remove foul tasting secretions or sores. (Sores are accumulations of dried secretions, microorganisms,
food particles, and epithelial tissues in the mouth which may have developed from illness or certain therapies.)
4. To maintain an intact and well-hydrated mucosa.
Equipment:
• Water in glass Face towel
• Small toothbrush Dental floss
• Toothpaste Antiseptic mouth wash
• Emesis basin (optional)
Tooth brushing (for CONSCIOUS PATIENT)

Procedure Rationale
If patient own oral care, provide the necessary
1. Assess patient’s ability to brush teeth.
articles. The nurse assists the patient as needed.
2. Assemble equipment and place on over bed table. Save time and energy.
3. Place patient in fowler’s position or semi-fowler
Comfort of patient.
position.
4. Place towel under the patient’s chin, tucking it
Prevent soiling of patient’s gown, anchors towel.
behind the shoulders.
Prevent spread of microorganisms, for infection
5. Wash hands and put on clean gloves.
control.
Toothpaste acts a cleaning agent. If no toothpaste is
6. Moisten toothbrush with water and spread a small
available, plain water may be used. Baking soda is a
amount of toothpaste on it.
substitute that also freshens the breath.
7. Hold brush at 45° angle and brush using small,
vibrating, circular motion with the bristles at the
Procedure allows thorough cleaning of the teeth,
junction of the teeth and gums. Use a back-and forth
gums, and tongue.
brushing motion over the biting surfaces of the teeth.
Brush the tongue last.
8. Allow patient to rinse mouth with water or
Provide comfort to the patient.
mouthwash (if desired) and expectorate into the
emesis basin. Wipe the patient’s mouth.
9. Rinse equipment and return to its proper place. Maintain cleanliness and orderliness in the ward.
Dispose used materials.
10. Return bed to its low position. Comfort of the patient.
Dental Flossing
• Flossing is carried out between the teeth and between the gums and each individual tooth to remove
plaque (plaque are microorganisms trapped in a mucous base which if not removed causes tooth and
gum disease).
• It involves inserting wax or unwaxed dental floss between all tooth surfaces and pulling the floss in see
saw motion taking care not to injure the delicate mucous membrane. After flossing, allow the patient to
rinse mouth to remove debris. It is recommended that flossing should be done once daily after brushing.
ORAL CARE FOR UNCONSCIOUS OR DEBILITATED PATIENTS

• Unconscious patients are susceptible to drying of mucosa-thickened salivary secretions because they are
unable to eat or drink, frequently breathe through the mouth, and often receive oxygen therapy. The
unconscious patient also cannot swallow salivary secretions that accumulate in the mouth. These
secretions often get into the lungs. Therefore, the nurse must protect the patient from choking and
aspirating.
Additional equipment:
• Anti-infective solution (e.g., hydrogen peroxide diluted in equal parts of
• water)
• Padded tongue blade
• Paper towels
• Petroleum jelly
• Disposable gloves
• Tongue blade wrapped in single layer of gauze
• Portable suction machine (optional) with suction catheter
PROCEDURE RATIONALE
Reveals patient’s risk for aspiration. Allows
1. Assess for presence of gag reflex. Position
secretion to drain from mouth instead of
patient in Sim’s or side-lying position with head
collecting in back of pharynx and prevents
turned well toward dependent side.
aspiration.
2. Explain procedure to patient. Unconscious patient may retain ability to
hear.
3. Wash hands and apply disposal gloves.
Reduces transfer of microorganisms.
4. Place paper towels on over bed table and
Prevent soiling of table top. Equipment
arrange equipment. Turn on suction machine
prepared in advance ensures smooth, safe
and connect tubing to suction catheter.
procedure.
5. Pull curtain around bed or close room door.
Provides privacy.
6. Raise bed to highest horizontal level; lower
Use of good body mechanics with bed in high
side rail.
position prevents injury to you and patient.
7. Bring patient close to side of bed and near
you, be sure patient’s head is turned toward Proper positioning of head prevents
mattress. aspiration.
8. Place towel under patient’s face and emesis

Prevents soiling of bed linen.
basin under chin.
9. Carefully retract patient’s upper and lower
teeth with padded tongue blade by inserting Prevents patient from biting down on fingers
blade quickly but gently between the back and provides access to oral cavity.
molars. Insert when client is relaxed if possible.
10. Clean mouth using brush or tongue blade

moistened with peroxide and water. Have
Brushing action removes food particles
second nurse suction as secretions accumulate
between teeth and along chewing surfaces.
during cleansing. Clean chewing and inner
Swabbing helps remove secretions and
tooth surfaces first. Clean outer tooth surfaces.
encrustations from mucosa and moistens
Swab roof mouth and inside cheeks. Gently
mucosa. Suction removes secretions loose
swab or brush tongue but avoid stimulating gag
debris and peroxide that can be irritating to
reflex (if present). Moisten clean swab or
mucosa.
toothette with water to rinse. Repeat rinse
several times. Suction any remaining secretions.
11. Apply thin layer of petroleum jelly to lips. Lubricates lips to prevent drying and
cracking.
Provides meaningful stimulation to
12. Explain that procedure is completed.
unconscious or less responsive patient.
13. Remove gloves and dispose in proper
receptacle. Prevents transmission of microorganisms.
14. Reposition patient comfortably, raise side

rail, and return bed to original position. Maintains patient’s comfort and safety.
15. Clean equipment and return to its proper Proper disposal of soiled equipment prevents
place. Place soiled linen in proper spread of infection.
receptacle.
16. Wash hands. Reduces transmission of microorganisms.
Determines efficacy of cleansing. After thick
17. Inspect oral cavity. secretions are removed, underlying
inflammation or lesions may be revealed.
18. Record procedure, including pertinent
Determines response of patient to nursing
observation (e.g., bleeding gums, dry mucosa,
therapy. Bleeding may indicate more serious
ulcerations, or crusts on tongue) and report any
systematic problems. Lesions of oral cavity
unusual findings to nurse in charge or
can be cancerous.
physician.

Oral

Uploaded by

Copyright:

Available Formats

Oral

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Oral

Uploaded by

Copyright:

Available Formats

Oral / Denture Care

Tooth brushing (for CONSCIOUS PATIENT)

ORAL CARE FOR UNCONSCIOUS OR DEBILITATED PATIENTS

8. Place towel under patient’s face and emesis

10. Clean mouth using brush or tongue blade

14. Reposition patient comfortably, raise side

You might also like