Mouth Care Session
For HCSWs in Practice
HCSW Link Development Nurse:
Tracy Culkin
Aim
 Discuss the anatomy of the oral cavity
 Describe how the mouth is normally
lubricated and kept moist
 Identify factors that may influence poor oral
health and hygiene
 Discuss the choice of equipment and
solution for patient use
 Discuss what may influence oral hygiene
 Identify the oral care assessment undertaken
by a RGN to plan mouth care
Anatomy of the Oral Cavity
How the mouth is normally
lubricated and kept moist ?
Which mouth lacks mucous
membranes?
Factors that may influence poor oral health
and hygiene
Illness Risk Factors
Diabetes
Limited/restricted fluids
Thyroid dysfunction
Mouth breathers
Oral disease/trauma
Confusion
Cerebrovascular disease
Depression
Debility
Terminal illness
Acute/chronic breathing disorders
Poor nutritional status
Oxygen therapy
Lack of motivation
Insufficient saliva
Inability to perform activity
Intensive care patients
Immunosuppressive, transplant pts
Risks Continued...
Drugs
Impact
Cytotoxic/Chemotherapeutic drugs
Reduces the auto-immune response
Corticosteroids
Affect the healing properties of tissues
Antibiotics
Alter the bacterial balance of
commensal organisms in the mouth and
allow candidal invasions
Antispasmodics
Alter gut mobility and reduce salivary
production
Antihistamines, Anticholinergics,
Psychotropic's, Antidepressants
These groups of drugs reduce salivary
production
Diuretics
Potential dry mouth due to increased
fluid loss
Morphine
Strong association with dryness of the
mouth
Risks Cont...
Treatments
Radiotherapy to head and neck
Reduces ability to eat/drink normally
Localised inflamation
Oxygen therapy
Un-humidified oxygen administered by
mask can dry mouth
Intermittent suction
Potential risk of damage to oral tissues
Restricted oral intake
Potential dehydration
Anaesthesia
Reduces oral secretion
Potential problems
Stomatitis
Inflammation and infection of the oral
mucosa
Oral Thrush
Caused by a yeast like fungus.
Ulceration
Ulcers
Dental caries
Decay and cumbering of tooth
choice of equipment for patient
use
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Gloves, Apron Clinical waist bag/bin
Tongue depressor
Torch for mouth examination
Toothbrush/denture pot
Mouth wash
Fluoride toothpaste / denture cleaner
Foam sponge sticks
Plastic beaker
Jug of water
Receiver
Box of tissues
Towel
choice of solution for patient use
Oral care products
When recommended
Sodium bicarbonate dilute one teaspoon in
500ml of warm water
Use once
When tenacious mucous is present or
mouth is crusted
Glycerine/ thymol tablets 1 tablet to a beaker of
water
Useful for refreshing mouth, plays no part in
cleaning. Effect 20 mins
Corsodyl rinse the mouth with 10mls for about
one minute twice a day
Highly recommend, inhibits bacterial growth
Nystatin 100,000 units four times a day after
food, usually for seven days
If patient wears false teeth, remove before
introducing
Oral fungal infections
Toothpaste, use a small amount on toothbrush
Highly recommended
Tap water, refreshing-ideal ph of seven
Recommended to moisten mouth
Pineapple cubes/juice tinned ok but better if
fresh
Ideal for dry mouths, contains a photolytic
enzyme that cleans the mouth
Emollient (Vaseline) apply to lips
Prevent cracked lips
Lip Balm (apply to lips only
Prevent lips cracking, easy to apply
What may influence oral hygiene
 Appropriate communication
 Considering the persons ability
 Hospital guidelines on mouth care
 Providing equipment and assistance (if needed)
 Encouraging the patient to participate
 Considering the environment
 Ensuring an appropriate position
 Documenting findings
Remember
“If you think a patient needs an oral assessment
notify a registered nurse to ensure the proper
treatment can be issued"
Thank you for your time
Please complete question sheet and
feedback sheet