Oral Care
By: Aubrey A. Dayrit, MA, RN
Providing Oral Care
PURPOSE
• Decreases microorganisms in mouth and on teeth
• Reduces the risk of cavities and mouth disease
• Decreases buildup of food residue on teeth
• Improves appetite and taste of food
• Promotes comfort
• stimulates circulation on oral tissues, tongue, and gums
• Improves appearance and self-esteem
Providing Oral Care
ASSESSMENT
• Client’s desire and need for oral care
• Client’s usual routine for oral hygiene
• Client’s knowledge of purpose and procedure
• Client’s ability to understand and follow instructions
• Presence of dentures
• Status of palate, floor of mouth, throat, cheeks, tongue,
gums, and teeth
Providing Oral Care
NURSING DIAGNOSES
• Impaired oral mucous membranes related to inadequate
oral cleaning
• Impaired dentition related to lack of knowledge
regarding dental health
Providing Oral Care
OUTCOME IDENTFICATION AND PLANNING
• Oral intake increased from 10% to 50%
• Mucous membranes and lips are intact
• Oral passage and teeth are clean
Providing Oral Care
SPECIAL CONSIDERATIONS IN PLANNING AND
IMPLEMENTATION
GENERAL
- use soft toothbrush or toothette for client receiving
anticoagulant therapy (heparin, warfarin/coumadin)
- dilute mouthwash for clients with oral lesions or
sensitive oral tissues
Providing Oral Care
SPECIAL CONSIDERATIONS IN PLANNING AND
IMPLEMENTATION
GERIATRIC
- Extra care: Loose teeth due retracting gums
Providing Oral Care
SPECIAL CONSIDERATIONS IN PLANNING AND
IMPLEMENTATION
- Encourage client to perform as much oral care as possible
and encourage family members to assist, when necessary
Providing Oral Care
SPECIAL CONSIDERATIONS IN PLANNING AND
IMPLEMENTATION
- If the patient is helpless make certain that the patient's mouth
receives care as often as necessary to keep it clean and moist, as
often as every 1 or 2 hours if necessary.
- The nurse should wear disposable gloves, and normally saline
solution; moisten the mouth with water (if allowed) and
lubricate the lips often enough to keep the membranes well
moistened.
Providing Oral Care
SPECIAL CONSIDERATIONS IN PLANNING AND
IMPLEMENTATION
- A patient receiving chemotherapy medication may have
bleeding gums and extremely sensitive mucous membranes.
Use sponge toothette for cleaning or substitute a salt water rinse
(1/2 tsp salt in 1 cup of warm water) for brushing of teeth.
Providing Oral Care
SPECIAL CONSIDERATIONS IN PLANNING AND
IMPLEMENTATION
DENTURE CARE
• Dentures should not be wrapped in toilet tissue or disposable
wipes because these are likely to be thrown away.
• Dentures should be stored in water to prevent drying and
warping of plastic materials.
Providing Oral Care
SPECIAL CONSIDERATIONS IN PLANNING AND
IMPLEMENTATION
DENTURE CARE
• Dentures should not be wrapped in toilet tissue or disposable
wipes because these are likely to be thrown away.
• Dentures should be stored in water to prevent drying and
warping of plastic materials.
MATERIALS AND SUPPLIES
• Padded tongue depressors
• Cotton balls/cotton applicators
• Mouthwash diluted in water
• Clean gloves
• Towel
• Petrolatum jelly
• Asepto syringe
• Kidney Basin
PROCEDURE
ACTIVITIES RATIONALE
1) Wash hands Reduces transfer of
microorganisms
2) Prepare materials and Promotes efficiency
supplies
3) Position client to semi- Decreases risks of aspiration
Fowler’s near the nurse with
client’s head to the side
4) Place towel under the Prevent the client my water
patient’s face and chin spills
5) Place kidney basin close to Promotes drainage of
the client’s chin mouthwash from mouth
PROCEDURE
PROCEDURE
ACTIVITIES RATIONALE
6) Wears clean disposable Prevents exposure to body
gloves fluids
7) Use non-dominant hand, to keep mouth open
place padded tongue
depressor on lower teeth
8) Moisten padded tongue Freshen mouth
depressor/cotton applicator
with mouthwash
PROCEDURE
ACTIVITIES RATIONALE
9) Clean mouth starting with Decreases microorganisms
chewing, inner surfaces of the growth in mouth
teeth, outer surfaces of the
teeth, then the roof of the
mouth, inside the cheeks and
the lips, and lastly, the tongue.
10) Rinse mouth with water Removes residue
using a clean
applicator/padded tongue
depressor
PROCEDURE
ACTIVITIES RATIONALE
9) Clean mouth starting with Decreases microorganisms
chewing, inner surfaces of the growth in mouth
teeth, outer surfaces of the
teeth, then the roof of the
mouth, inside the cheeks and
the lips, and lastly, the tongue.
10) Rinse mouth with water Removes mouthwash
using a clean secretions
applicator/padded tongue
depressor
PROCEDURE
ACTIVITIES RATIONALE
11) Use asepto syringe to
aspirate excess water in the
mouth
12) Remove kidney basin and
towel
13) Dry the lips with a towel
PROCEDURE
ACTIVITIES RATIONALE
14) Discard used gloves
15) Applies petrolatum jelly Moisturizes lips
(per Doctor’s order) with a
clean cotton applicator
16) Place client to
comfortable position
17) Clean used articles and Promotes clean environment
discards disposable materials
PROCEDURE
ACTIVITIES RATIONALE
18) Wash hands Reduces transfer of
microorganisms
19) Documents observations:
Characteristics/status of the
mucous membranes and lips,
odor, presence of oral
thrush/sore
EVALUATION
Were desired outcomes achieved? Examples of Evaluation
includes:
• Desired outcome met: Oral intake increased from 10% to
50%
• Desired outcome met: Mucous membranes and lips are
intact
• Desired outcome met: Oral passage and teeth are clean
DOCUMENTATION
The following should be noted on the client’s chart:
• Amount of care done by client
• Client’s response to activity
• Condition of oral cavity and lips
SAMPLE DOCUMENTATION
Date: 1/23/19
Time: 800am
Oral care performed with client assistance. Client
fatigued after brushing back teeth but expressed
interest in grooming activity. Mucous membranes
moist. Lips moist. Skin intact.
Thank you!
