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Oral Care

Oral Care. Aims. By the end of the session the participant will: Be familiar with the structures within and around the mouth Be aware of the negative impact on general health which can occur due to poor oral health Know the correct equipment to use when carrying out oral care. Oral Care.

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Oral Care

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  1. Oral Care

  2. Aims By the end of the session the participant will: • Be familiar with the structures within and around the mouth • Be aware of the negative impact on general health which can occur due to poor oral health • Know the correct equipment to use when carrying out oral care

  3. Oral Care • Poor oral hygiene is a common cause of distress for patients and families • Poor care may be due to lack of training, knowledge, inconsistent care • Not always a high priority • Essential for patient comfort

  4. Risk Factors for Oral Complications • Systemically ill, terminal illness, unconscious patient, tracheostomy • Oxygen therapy, mouth breathing, nil by mouth. • Naso – gastric/peg feeding • Chemotherapy/radiotherapy, drug therapy • Ill fitting dentures • Diabetes • Dementia

  5. Consequences of poor oral care • Pneumonia • Septicaemia • Endocarditis • Pain • Xerostomia (dry mouth) • Halitosis • Difficulty eating and drinking • Withdrawal • Low mood

  6. Good Oral Care • Frequent inspection important using a pen torch, tongue depressor and gloved finger • Have an understanding of the possible risk factors • Examine in and outside the mouth • Early detection/reporting of problems • Need instruction on specific requirements for that patient

  7. Dentate Patients (own teeth) • Brush teeth at least twice per day with toothbrush and fluoride toothpaste • Moisturise lips if necessary with a water based lubricating gel • ONLY use foam swabs soaked in water if using a toothbrush is too painful or impossible,

  8. Care of Dentures • Remove and brush with a toothbrush and water after every meal • Rinse mouth with water to remove debris • Moisturise lips if necessary with water based lubricating gel • Remove and soak overnight in water • If oral infection is present, e.g. candida, dentures should be soaked in 1% sodium hypochlorite solution 2ml mixed with 160ml of tap water. If they have metal parts – soak in chlorhexidine 0.2%

  9. Oral Problems • Candida (thrush) • Bacterial infections • Xerostomia(dry mouth) • Mucositis • Cold sores • Ulcers • Angular cheilitis

  10. Candida

  11. Dry mouth • What causes a dry mouth? • What problems can a dry mouth cause?

  12. Drugs – lots of them Radiotherapy Oxygen Mouth breathing Causes

  13. Complications of dry mouth • Decay • Gum recession and loss of teeth • Difficulty eating • Difficulty speaking • Trauma of mucosa • Halitosis

  14. Dry Mouth (Xerostomia) • Continue brushing teeth twice per day with fluoride toothpaste • Sips of and rinsing with tap water • Artificial saliva – Avoid glandosane in patients with their own teeth Saliva Orthana has a porcine extract so is not suitable for some patients due to culture • Oral balance gel • Sugar free chewing gum • Review of medication

  15. Cold sore

  16. Aphthous ulcer

  17. Angular cheilitis

  18. Treatment of Painful Mouths • Some patients may need pain relief such as co-codamol or even morphine in severe cases • Avoid strong, acidic mouthwashes e.g. brand makes • Benzydamine (Difflam) mouth wash has local anaesthetic. It can be diluted 1:1 if stinging • Topical steroid for ulcers such as hydrocortisone pellets

  19. Practical Session…

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