TMF Health Quality Institute

1. TMF Health Quality Institute Training 2 Shelley Mitchell, RDH Shelley.Mitchell@tmf.org

2. Daily oral care strategiesand oral care planning What you will learn today • What to include in the resident oral care plan • How to set up for providing daily oral care • How to perform proper daily oral care • Adaptations for special needs

3. Each resident should havean individualized oral care plan The resident’s dentist or the nursing home dentist should help in making the daily oral care plan.

4. Oral Care Plan • Teeth, dentures or partials • Can brush their own teeth • Preferred tools • Special precautions or restrictions

5. Special considerationsfor Oral Care Plan • Dry mouth • Thrush • Ulcerated mouths • Special restrictions

6. For the resident with Dry Mouth • Offer plenty of water • Use artificial saliva products • Xylitol products • Offer water-based lip balm to keep lips moist

7. For the resident with Thrush • Antifungal prescription medications • Soak dentures overnight in Chlorhexidine

8. For sore, ulcerated mouths • Consult with a doctor or dentist for a prescribed analgesic mouth rinse • Offer water to drink • Consider Vitamin C to promote healing

9. Special restrictions • A resident should NOT be given mouthwash, toothpaste or water if: • Comatose • Care-resistant • Nothing by mouth (NPO) • Swallowing problems • Cannot spit

10. Setup for oral care

11. Residents with dentures

12. Take60secondseach day to perform a daily oral health assessment

13. Proper oral hygiene techniques

14. While you are setting up supplies, greet the resident and explain what you are doing

15. Positioning resident for care

16. After positioning the resident

17. How much toothpaste? This is TOO MUCH toothpaste. Should be pea sized.

18. How to brush teeth

19. How to brush teeth (cont’d)

20. Brush teeth twicea day for two minutes • If residents are brushing their own teeth, do not rush them • If you can only brush once in a day, night brushing is the most important

21. How to floss

22. Use an interproximal brushbetween teeth

23. Special adaptations

24. Consider using a child’s toothbrush

25. Clean dentures daily

26. Guidelines for denture care

27. Partial denture cleaning • Clean the partial the same as a full denture • Be careful when holding and cleaning the clasps Clasp

28. Additional resources • Texas Oral Health Coalition: http://txohc.org Access to Dental Care Resources: • Health Resources & Services Administration: “Find a Health Center”- Health Centers provide high quality preventive and primary health care, even if you do not have insurance. Search for locations near you. https://www.hrsa.gov/index.html • 2-1-1 Texas: If you do not have Medicaid or if you are 21 years old or older, 2-1-1 is a free help line that is answered in more than 90 languages, 24 hours a day, 7 days a week. An operator can help you find a dentist near you. You can also search online by zip code. You can get more information about 2-1-1 Texas @ http://www.211texas.org/ • Mouth Healthy: Brought to you by the American Dental Association (ADA). “ADA Find a Dentist” can search by zip code, miles away, discipline of dentistry, patient type (geriatric) and payment options (Medicaid), variety of insurance and payment plans. http://www.mouthhealthy.org/en • Texas Association of Community Health Centers: Dental help for uninsured individuals. Click on “Find a Community Health Center.” You can search by zip code, miles away and services. https://www.tachc.org/

29. Thank you for joining me todayCongratulationsYou are Oral Care Champions Thank you to the University of Kentucky College of Dentistry for content and illustrations used in this presentation. The Oklahoma State Department of Health (OSDH) is an equal opportunity employer and provider.