Oral Hygiene and Denture Care

Oral hygiene is essential for patient health and comfort. Poor oral care can lead to dental problems, infections, aspiration pneumonia, and decreased nutritional intake. CNAs perform oral care daily and for patients who cannot do it themselves.

Importance of Oral Hygiene

Health Benefits:

• Prevents tooth decay and gum disease
• Reduces risk of aspiration pneumonia
• Removes bacteria that can cause infections
• Maintains ability to eat and speak
• Supports overall health (linked to heart disease, diabetes)

Comfort Benefits:

• Freshens breath
• Improves taste of food
• Enhances self-esteem
• Promotes comfort and well-being

Oral Care for Conscious Patients

Equipment Needed:

• Toothbrush (soft bristled)
• Toothpaste (fluoride)
• Cup of water
• Emesis basin
• Towel
• Lip moisturizer

Procedure:

1. Perform hand hygiene and gather supplies
2. Position patient upright (at least 45 degrees)
3. Place towel across chest
4. Allow patient to brush if able (provide assistance as needed)
5. Brush all surfaces of teeth using gentle, circular motions
6. Brush tongue gently (back to front)
7. Have patient rinse and spit into emesis basin
8. Offer lip moisturizer
9. Clean and store equipment

Oral Care for Unconscious Patients

Unconscious patients require special care to prevent aspiration (fluid entering lungs).

Critical Safety Measures:

• Position patient on their side (lateral position)
• Use minimal liquid to prevent aspiration
• Use sponge swabs or toothettes instead of toothbrush
• Apply suction if available to remove excess fluid
• Never pour water into an unconscious patient's mouth

Procedure:

1. Position patient on side with head slightly lowered
2. Use moistened sponge swab or toothette
3. Clean all surfaces of mouth including tongue, cheeks, and gums
4. Use fresh swab for each area
5. Apply mouth moisturizer to lips and oral tissues
6. Check for pooled secretions and remove
7. Return patient to comfortable position

Denture Care

About 20% of adults over 65 wear complete dentures. Proper denture care maintains oral health and denture function.

Denture Handling Rules:

Cleaning Procedure:

1. Ask patient to remove dentures (or remove with tissue if needed)
2. Line sink with towel to prevent breakage if dropped
3. Rinse dentures under cool running water
4. Apply denture cleaner to denture brush
5. Brush all surfaces (inner, outer, chewing surfaces)
6. Rinse thoroughly under cool water
7. Store in labeled denture cup with water or denture solution
8. Provide oral care to gums, tongue, and palate before reinserting

When Dentures Are Out:

• Clean the patient's gums, tongue, and palate with soft toothbrush or sponge swab
• Check for irritation, sores, or lesions
• Report any mouth problems to the nurse

Special Oral Care Situations