Overview
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The care of a person's mouth is an important element in
nursing care. It entails brushing the teeth, flossing between them, and checking the inside
of the mouth and gums. It also include cleaning the dentures if the
person has them.
The mouth may become dry due to high fever, vomiting
or lack of fluid intake. Mouth care helps to stimulate the flow of saliva which
prevents it from becoming sore. Keeping the person mouth clean, moist and free
from infection is important in the prevention of dental problems. Cleaning
the teeth regularly helps to remove plaque and debris which cause tooth
decay and bad breath. Good oral hygiene may also help to increase
appetite. Mouth care should be performed at least in the morning and
at bedtime. Cleaning or rinsing the mouth after meals should be done
when possible.
If you have any questions or concerns about daily mouth care or notice
any unusual symptoms in the person, please consult your healthcare professional.
Tips on Mouth
Care
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Eat
a well-balanced, and low-sugar diet.
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Encourage
high fluid intake, if the person is not under any fluid restriction, to
keep his mouth fresh.
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Eat
citrus fruits (eg. oranges), unless this is against medical advice, as these stimulate
the production of saliva which naturally cleanse the mouth.
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If
the person's mouth is dry, and he is on restricted fluids, sugar-free chewing
gum may encourage the natural flow of saliva and helps to keep his mouth
moist.
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Breathe
through the nose because mouth breathing makes the mouth dry.
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Observe and routinely inspect the oral mucosa for signs of
complications. Please refer to
Signs of
Trouble.
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Brush
teeth every morning, after meals, and at bedtime.
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A person
who wear dentures should rinse the mouth and dentures after meals.
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Have
well-fitting dentures.
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Overcoming Physical Disabilities
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For a person who find it difficult to handle toothbrush, you may
improvise by enlarging a toothbrush handle with wrapping tape or
inserting it into a rubber ball or a bicycle grip handle. Do
consult your dentist about investing in a battery-operated toothbrush
(easier for some people to manage) and other specialty products.
Signs of Trouble:
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Mouth pain
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Dry
cracked lips
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Dry
furred tongue
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Bleeding
gums
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Hoarse-voice
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Sores
inside the cheeks and gums |
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Decreased
appetite
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Difficulty
swallowing
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Unpleasant
taste in the mouth
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Bad
smell from he mouth
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White
patches on the tongue or inside the mouth
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Brushing Teeth in Bed
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If the person is unable to get out of bed, but can be propped up and
is conscious and alert, you can help by bringing the equipment he needs
to the bed. Let him help as much as he can. Items required include
a soft bristles toothbrush, toothpaste, a glass of water, a small bowl or
dish to spit into, a towel and tissues to wipe the mouth.
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Help
the person to a sitting position.
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Cover
his chest and shoulders with a towel to keep his clothes and bed from getting
wet.
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Allow the
person to brush his own teeth and provide assistance when
necessary.
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If
the person cannot hold the toothbrush, assist him in brushing his teeth:
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Wet the
toothbrush and put a small amount of toothpaste on it.
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Place the
brush at a 45-degree angle to the gum line and gently
brush the outside of the upper teeth downward from the
gum line. Brush the bottom teeth upward from the gum
line.
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Use short and
gentle strokes to prevent gum damage.
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Brush the
chewing part of the bottom and top teeth using a back
and forth motion.
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Use the front
tip of the toothbrush to brush the insides of the teeth.
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Complete the
procedure by gently brushing the gums and tongue.
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Do not put
toothbrush too far in the back of the mouth, which can
cause gagging.
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Provide
water for the person to rinse his mouth if he is able. Hold the bowl
under his chin so that he can spit out the water.
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If the person
wears dentures, clean
and rinse the dentures before replacing them in his mouth. Please
refer to
Care of Dentures and Mouth.
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Wipe
and dry the person's lips and chin. Make the person comfortable.
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Performing Mouth Care
Using Gauze/Cotton Swabs
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This method is useful for unconscious person or those who cannot be
propped up in bed.
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Wrap a towel under the person's chin
and round his shoulders to protect his clothing.
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Prepare a cup of gargle solution dilute
according to the manufacturer's instruction.
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Hold the cotton ball/gauze with a forceps
and dip it into the prepared solution. Squeeze out excess solution
to prevent it from dripping into person's throat which may cause choking
(aspiration).
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The comatose person requires suctioning to
prevent aspiration during oral care.
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Gently clean all the surface of
the mouth including the teeth.
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Use fresh cotton balls/gauze in each
dip to keep the solution fresh.
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Do
not put cotton balls/gauze too far in the back of the mouth, which
can cause gagging.
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Brush the tongue because it harbors
bacteria that can cause dental problems.
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Clean the gum whether or not the
person is wearing dentures.
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Clean
and rinse the dentures and replace in the person's mouth.
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Finally,
wipe and dry the person's lips and chin; make the person comfortable.
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Note:
Alternatively, medicated
cotton swab sticks
can be used directly and conveniently to clean the mouth
without any further addictives.
These items
are commercially available at pharmacies.
Care of Dentures and Mouth
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Brush
or soak dentures with a denture cleaner in the morning, after meals and at
bedtime.
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When
using cleaning product, follow the instructions that come with the cleaner.
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The
first step in cleaning dentures is to rinse away loose food particles thoroughly.
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Brush
the dentures with soft bristles toothbrush under running water, holding it
with the palm of your hand. Brush every surface, scrubbing gently to
avoid damage. You may brush the denture with denture cleanser.
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Dentures
are very delicate and may break if dropped. Put a washcloth in the
sink when washing them to prevent breakage from dropping.
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Always
soak the dentures in a denture cup when not in use. Dentures may lose
their shape if they are allowed to dry out.
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Never
soak dentures in hot water because this can cause them to warp.
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Clean
the person's mouth after removing the dentures or ask him to rinse his
mouth with water mixed with mouthwash.
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Use
a soft toothbrush to massage the gums and roof of the mouth and tongue.
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Soak
dentures overnight in a denture cup filled with a denture cleaning solution
using tablets or paste. The solution will help to loosen and remove
stains and deposits.
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Rinse
the dentures in running warm water again after soaking, and brush natural
teeth, before putting dentures back into the person's mouth.
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Loose
dentures can cause irritation in the mouth. Check the inside of the
mouth for sores that may be caused by poorly fitting dentures.
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If
dentures are causing sores, remove the dentures until the sores healed.
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How to Remove a Person's Dentures
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Help the person to remove his denture if he cannot do it by himself.
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Put
on gloves or use a tissue paper to hold the dentures.
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To
remove a full denture, hold the denture with your thumbs and index fingers
and tilt it away from the gum. Gently wiggle the denture and pull
it forward and out of the mouth.
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Put
the denture in the denture cup.
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To
remove a partial denture, lift the metal clamp with your fingertip.
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Clean
the person's mouth after the dentures are removed.
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Putting Dentures Back in a Person's
Mouth
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Encourage the person to wear his dentures if he has them, unless there is
some reason for not doing so. They
will improve his ability to chew food, and will also improve speech and
facial appearance. Help the person to wear his denture if he cannot do
it by himself.
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Put
on gloves or use a tissue paper to hold the dentures.
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Apply
adhesive liner or fixative to the dentures if the person uses them.
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Wet
the dentures before putting them in the mouth to help seal them to the gums.
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Begin
by gently inserting upper denture. Use your thumbs and index fingers
to press the denture firmly in place, sealing it against the palate.
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Repeat
for the lower denture.
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Check
the inside of the mouth for sores. If present, refrain from wearing
dentures until the sores healed. Consult your doctor.
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Check
with the person if the dentures feel comfortable when you have place them in
his mouth.
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