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MOUTH CARE

MOUTH CARE. IMRAN IQBAL CLINICAL INSTRUCTOR. DEFINITION. Oral hygiene is the practice of keeping the mouth clean and healthy by brushing and flossing to prevent tooth decay and gum disease .

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MOUTH CARE

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  1. MOUTH CARE IMRAN IQBAL CLINICAL INSTRUCTOR

  2. DEFINITION • Oral hygiene is the practice of keeping the mouth clean and healthy by brushing and flossing to prevent tooth decay and gum disease. • Mouth care is the provision of appropriate to ensure that the tissue and structure of the mouth are in healthy state.

  3. MOUTH CARE • Maintaining a clean and comfortable oral cavity helps patients to recover and reduces the risk of their health declining. • They will be able to communicate better, feel better, eat more easily and will maintain dignity.

  4. WHO • All patients admitted to hospital for longer than 24 hours. • Unconscious patients. • Patients on NG or PEG tube feed. • Patient receiving O2 therapy / assisted ventilation • Mouth breathing patients. • Physical or mental disabilities.

  5. WHEN • Within 24 hours, or within 4 hours for patients who are: • Complex needs • Critically ill • Integrated Care Priorities • Last Days of Life • Patient undergoing chemotherapy • Elderly patients

  6. HOW • Assessing seven areas of the mouth: • And grading each one: • 1. Health Status • 2. Level of Support • 3. Lips/Tongue/Soft Tissues 0 = Healthy • 4. Saliva 1 = Changes • 5. Gums and Cleanliness 2 = Unhealthy • 6. Natural Teeth • 7. Dentures

  7. Assessing the mouth • Get consent from patient – if patient refuses or cannot be assessed because they pose a risk to staff (e.g. by biting) • Record this on the sheet and try again the next day. • Sit the patient upright or semi-supine where possible to reduce aspiration/ choking risk. • A good light source is essential - use a pen torch if one is available (ensure it has been wiped over with alcohol wipe first). • A wooden tongue depressor may be useful with some patients with uncontrolled tongue movements. • Alternatively, a soft toothbrush can be used to encourage the patient to open their mouth and to gently move soft tissues out of the way.

  8. Assessing the mouth • Assess the soft and hard tissues of the mouth in a systematic way. • Assess lips while talking to patient. • Ensure their privacy and dignity is maintained. • If the patient wears dentures, ask them to remove them while you check their mouth. • Check buccal mucosa, hard and soft palate. Remember to check the corners of the mouth. • Look for ulcers, blisters, white/red/speckled patches, food debris and swellings. • Healthy mucosa looks smooth and moist.

  9. Assessing the mouth • Ask patient to stick tongue out, to sides and then to top of mouth (if they are able) • Note whether there is a normal amount of saliva present – do the tissues look dry? • Assess the health of the gums – • look for bleeding (ask patient if they bleed during tooth brushing), blisters, ulcers, white or red patches, swellings, or “looseness” of tissue around the teeth. Healthy gums are pale and firm with a stippled surface.

  10. Assessing the mouth • If the patient has dentures, check that they are clean with no broken areas. • Complete the Mouth care Assessment Form. • Would be graded as healthy, changes or unhealthy • Seek urgent medical attention for any patient with a facial swelling or a compromised airway.

  11. EQUIPMENTS • Clean Tray • Kidney dish • Plastic Beaker • Small headed soft tooth brush • Tooth paste • Spatula • Torch • Tissues • Clinical Waste bag • Gloves • Apron • Antiseptic Solution • Lip balm • Mouth gag

  12. PROCEDURE • Collect and prepare all the equipments in order to carry out procedure smoothly and without unnecessary stoppages

  13. PROCEDURE • Explain the procedure to the patient in order to gain the consent and cooperation.

  14. PROCEDURE • Put curtain around bed to ensure privacy. Mouth care is both invasive and potentially embarrassing interaction.

  15. PROCEDURE • Wash hands and put on gloves and apron to prevent contamination with body fluids (Saliva) and reduce the risk of cross-infection

  16. PROCEDURE • Drape a towel over the patient's chest. ...

  17. PROCEDURE • Ensure the patient is in a comfortable position. Either in Bed or chair

  18. PROCEDURE • Gently turn the patient's head toward you, and open the mouth using a tongue depressor in one hand.

  19. PROCEDURE • Assist the patient with removing denture to gain the access to the oral cavity.

  20. PROCEDURE • Using a toothbrush, clean the patient's mouth including teeth, gums, and tongue. ...

  21. PROCEDURE • When you have completed brushing, suction saliva and tooth pasted from the patient's mouth.

  22. PROCEDURE • Document the care provided and report any changes or finding.

  23. PROCEDURE • Dispose of any disposable material to maintain safety and prevention spread of infection.

  24. PROCEDURE • Assist the conscious patient, Put paste on brush and be there for any help needed.

  25. ANY QUESTION?

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