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

 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

Risk Factors
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

 Pneumonia
 Septicaemia
 Endocarditis
 Pain
 Xerostomia (dry mouth)
 Halitosis
 Difficulty eating and drinking
 Withdrawal
 Low mood

 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

 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,

 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%

 Candida (thrush)
 Bacterial infections
 Xerostomia (dry mouth)
 Mucositis
 Cold sores
 Ulcers
 Angular cheilitis

 What causes a dry mouth?
 What problems can a dry mouth cause?


 Drugs – lots of them
 Radiotherapy
 Oxygen
 Mouth breathing

 Decay
 Gum recession and loss of teeth
 Difficulty eating
 Difficulty speaking
 Trauma of mucosa
 Halitosis

(
)
 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

 Some patients may need pain relief such as cocodamol 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