Policy:
Authorized by:
Oral Hygiene – SAMPLE ONLY
Policy Number:
Issued on:
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The mandatory legislation requirements as outlined in the Long Term Care Act 2007 – Ontario
Regulations 79/10 under section 34: Oral Care will be used to guide the content of this Policy.
Purpose: All residents will receive or be provided with oral hygiene at a minimum of twice daily
(morning and night). This oral hygiene will be individualized to meet the preferences and the abilities of each resident based on an assessment. This will be summarized into a written plan for oral care that is updated on a quarterly.
Applicability: This policy applies to all nursing department staff (registered and non-registered) who provide personal hygiene to residents.
Definitions:
Oral hygiene: means the cleaning of the teeth/denture/partials, gums, and tongue
Procedures:

For all residents an oral health assessment will be completed on admission using the Oral
Health Assessment Tool (OHAT), and will be repeated on a quarterly basis.
 Front line staff will perform a visual inspection of the oral cavity on a daily basis and will report any changes to the registered staff.
Daily visual inspection procedures:
Perform hand hygiene and put on a pair of gloves
Ask client to open mouth, if the resident will not open their mouth try again later or change you approach.
When the mouth is open, using a tongue depressor if necessary inspect the following areas within the oral cavity:
A.
Lips  should appear pink, smooth, and moist
B.
Teeth or dentures  should be smooth, clean, with no plaque build-up or debris, no cracked teeth and if the resident wears dentures, they should be well fitting
C.
Mucosa of the mouth  should be pink, moist and intact
D.
Saliva  should be watery and not ropy or absent
E.
Tongue  moist, pink and no coating
F.
Gums  pink, firm, and are attached to the bottom of the teeth with no bleeding present

Policy:
Authorized by:
Oral Hygiene – SAMPLE ONLY
Policy Number:
Issued on:
Page: 2 of 3
Based on the residents’ care plan the following procedures will apply to denture cleaning and oral hygiene: a.
Cleaning dentures – if resident is unable to perform self-care on their own i.
Take the residents’ kidney basis, line with a face towel, and fill with lukewarm water ii.
Put on gloves iii.
Ask resident to remove dentures, if they are unable to do this task, grasp the top denture with thumb and index finger and pull downward, to remove the bottom denture, just lift and rotate one side slightly to remove from the residents’ mouth iv.
Place dentures into the kidney basin v.
Holding dentures over the kidney basis, apply a small amount of toothpaste to a denture brush or a soft bristled toothbrush and gently brush the dentures to remove plaque and food debris vi.
Rinse the dentures in the kidney basin vii.
If reinserting dentures into the residents’ mouth, apply a thin layer of denture adhesive if they wear it and moisten dentures to help with insertion viii.
Ask resident about the comfort and fit of the dentures ix.
If dentures have been removed for the night, place them in their labelled denture cup in clean water along with a denture tablet based on resident preference x.
Remove gloves and dispose, wash hands, and clean-up equipment and supplies and store residents personal care items appropriately b.
Cleaning residents’ teeth – if the resident is unable to brush teeth on their own i.
Arrange the necessary equipment at the place where you will be doing the oral hygiene for the resident. If at all possible, bring the resident to the bathroom as the cues help with performing oral hygiene. If doing oral care in bed, ensure the head of the bed is raised ii.
Place a towel over the resident chest to prevent any dripping onto the residents cloths iii.
Put on gloves iv.
Apply a pea-sized amount of fluoridated toothpaste to the residents brush v.
Hold the brush at a 45-degree angle and brush using a downward motion of the bristles starting at the gum-line and moving down the teeth. Make sure you brush the front, back, and tops of the molars

Policy:
Authorized by:
Oral Hygiene – SAMPLE ONLY
Policy Number:
Issued on:
Page: 3 of 3 vi.
Brush the residents tongue, by asking them to open their mouth wide and carefully brush the tongue making sure not to place the brush too far back onto the tongue to stimulate the gag reflex vii.
Floss between all of the residents’ teeth, this will probably only apply to those who are able to follow instructions viii.
Have the resident rinse their mouth with a few sips of water and spit into a kidney basin or sink ix.
Have the resident now rinse with mouth wash for 30 seconds and have them spit into a kidney basin or sink x.
Remove gloves and dispose, wash hands, and clean-up equipment and supplies and store residents personal care items appropriately
Outcome: Maintenance of oral hygiene through brushing, flossing, and rinsing of residents mouths to prevent and control oral infections and maintain the strength of teeth and structures within the mouth. The result is comfort, promoting nutrition and verbal communication
References:
Long-Term Care Homes Act, 2007 – Ontario Regulations 79/10, Section 34. Retrieved from http://www.search.e-laws.gov.on.ca/en/isysquery/021f443d-54e2-48d1-98fa-
0a6b0d5a7c40/1/doc/?search=browseStatutes&context=#hit1
Perry, A., & Potter, P. (2006). Clinical nursing skills and techniques. (6 th ed.). Elsevier Mosby: St. Louis,
Missouri.
Registered Nurses’ Association of Ontario (2008). Oral Health: Nursing assessment and interventions.
Retrieved from: http://www.rnao.org/Storage/50/4488_Oral_Health-Jan9.09-web.pdf