IA - Health Advisor

Why do you need it? Mouth care is important to help prevent tooth decay and infections (in-FEK-shuns) inside the mouth.

When should mouth care be given? Mouth care should be done at least once in the morning and at bedtime. Cleaning the mouth after meals should be done when possible. Some people, such as those who are vomiting, need mouth care more often. People who wear dentures should rinse the mouth and dentures after meals. Dentures should be cleaned well at least once every day.

How do you brush a person's teeth? Ask if the person wants to brush his teeth. Let him help as much as he can. The following steps will help when brushing a person's teeth:

Put the following items within easy reach.

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  Disposable gloves.
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  Hand towels.
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  Toothbrush with soft bristles.
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  Toothpaste that contains fluoride (FLOOR-ide).
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  Pitcher with fresh water and a cup. Include mouthwash if needed.
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  Emesis (EM-e-sis) basin or other container to spit the water or mouthwash into.
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  Dental floss.
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  Mirror.

Get the person ready.

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  Help the person to a sitting position to make it easier to brush his teeth. If he cannot sit, raise the head of the bed if his caregiver says it is OK.
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  Cover the person's chest and shoulders with a towel to keep his clothes and bed from getting wet.

Brush the person's teeth.

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  Wash your hands and put on disposable gloves.
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  Wet the toothbrush and put a small amount of toothpaste on it.
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  Ask the person to open his mouth, or gently open his mouth yourself.
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  Gently brush the outside of the upper teeth downward from the gum line. Use the front tip of the toothbrush to brush the insides of the upper teeth.
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  Brush the bottom teeth upward from the gum line. Use the front tip of the toothbrush to brush the insides of the lower teeth.
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  Molars are the large, flat teeth in the back of the mouth. Brush the tops of all molars with a gentle back and forth motion.
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  Gently brush the person's tongue. Do not brush too far back on the tongue. This could cause the person to gag.
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  Give the person water to rinse his mouth. Hold the basin under his chin so he can spit out the water. Offer mouthwash if he would like to use it.
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  Use a towel to dry the person's face.

Floss the person's teeth.

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  Use a piece of dental floss that is at least 12 inches (30 cm) long.
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  Wrap the floss around the index or middle finger of each hand.
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  Start with the back teeth. Put the floss between two teeth. Slide it down (or up) toward the gum.
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  Gently pull the floss up and down and back and forth between the teeth. Be careful not to push too hard against the gums.
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  Keep moving the floss on your fingers so you use a clean section between each pair of teeth.
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  Mix water and mouthwash in a glass and ask the person to rinse his mouth. Be sure to hold the emesis basin close to his mouth while he does this.
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  Use a towel to dry his face.
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  Rinse the toothbrush with clean water. Throw away the dental floss. Put all supplies away. Be sure to put the toothbrush in a place where it can dry out well.

How do you use an oral irrigating (ir-i-GA-ting) device?

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  An oral irrigating device may be unsafe in people with swallowing problems. Check with the person's health caregiver before using this device. Even if you use an oral irrigating device, you should also brush and floss the person's teeth.
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  Some people use an oral irrigating device to remove food from between their teeth. This is a machine with an electric motor and a water container. A tube with a plastic tip is attached to the water container. When the device is turned on, a throbbing jet of water shoots from the tip. The force of the stream can be changed so that it does not hurt the gums. The tip is moved along the gum line and aimed between the teeth. You can buy this device at a drug or medical supply store.
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  The device can remove bits of food from areas hard to reach with a brush or dental floss. These areas may include bridgework or dental wires. An oral irrigating device may be used for people with medical problems, such as an injured jaw. The following steps will help when using a mouth-irrigating device:

Put the following items within easy reach.
Disposable gloves.

Hand towel.

Emesis basin.

Oral irrigating device.

Pitcher with fresh water and a cup.

Mouthwash or salt solution (if needed).
Soap.

Get the person ready.

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  Roll the person on his side. This prevents water from running down his throat.
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  Cover his chest and shoulders with a towel and tuck it under his chin. This helps to keep him dry and the bed from getting wet.
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  Put the emesis basin on the bed, close to the person's cheek.

Use the oral irrigating device.

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  Wash your hands. Put on disposable gloves.
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  Plug the device into an electrical outlet.
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  Fill the container with water, or with the liquid suggested by your health caregiver.
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  Attach a clean tip to the tubing in the water container.
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  Adjust the dial to the pressure that is comfortable. Start with a low setting on the dial, especially if the person's gums bleed easily.
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  Ask the person to keep his mouth slightly open to keep water from spraying out.
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  With the plastic tip in the mouth, direct the water to the gum line and between the teeth.
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  Move the tip around the gums and all of the teeth.
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  Do not direct the water to the tongue or under the tongue.
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  Give the person time to spit the water into the emesis basin.

Store the oral irrigating device.

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  Unplug the device.
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  Remove the tip from the tubing.
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  Throw away the remaining liquid from the container.
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  Clean the plastic tip with a cleaning solution, or follow the directions that come with the device.
  Clean and put away all the other items.

How do you give mouth care to a person who wears dentures? Giving good mouth care to a person's dentures is as important as giving care to his own teeth. The following steps will help you give mouth and denture care.

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  Put the following items within easy reach.
  Disposable gloves.
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  Hand towel and washcloth.
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  Soft bristle toothbrush or denture brush.
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  Denture cup, small pan, or emesis basin.
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  Toothpaste.
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  Denture cleaning product.
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  A cup and pitcher filled with fresh water.
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  Small gauze pads.
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  Mouthwash.

Remove the person's dentures. Ask the person to remove his dentures or follow the steps below to remove them:

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  Wash your hands. Put on disposable gloves.
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  Remove the upper denture first.
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  Firmly hold the front and inner part of the denture plate with your thumbs and index (second) fingers. Use a small gauze pad to hold the denture plate. Put your index fingers close to the edge of the denture. Press your fingers to break the seal between the gum and the denture. Gently wiggle the denture and pull it forward and out of the mouth. Put the denture in the denture cup.
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  Next, remove the lower denture. Follow the same steps as you used to remove the upper denture.

Clean the person's mouth after removing the dentures.

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  Ask the person to rinse his mouth with a mixture of water and mouthwash.
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  Use a soft bristle toothbrush to massage the gums, the roof of the mouth, and the tongue.
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  Check the inside of the mouth for sores or irritation that may be caused by poorly fitting dentures.
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  Clean the dentures.
  Add lukewarm (slightly warm) water to the denture cup and dentures.
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  Lay a washcloth in the sink to keep the dentures from breaking if they are dropped into it.
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  Place the denture cleaning product in the denture cup. Follow the instructions that come with the cleaner. If you do not use a denture cleaning product, use toothpaste to carefully brush the dentures. Rinse them with clean water.
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  Clean the denture cup and fill with fresh lukewarm water.
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  Place the clean dentures back in the cup.

Put the dentures back in the person's mouth.
Apply adhesive (ad-HE-siv) liner or fixative to the dentures if the person uses them.

Wet the dentures before putting them in the person's mouth to help seal them to the gums.

What should be done after giving mouth care to a person? Always help the person back to a comfortable position after doing mouth care. If a hospital bed is used, be sure both side rails are up before you leave. Clean and put away the mouth care supplies. Be sure to put the toothbrush in a place where it can dry out well.

Call the person's caregiver if:

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  The person has new sores in his mouth.
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  The person has trouble breathing after mouth care.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn how to give mouth care. You can then discuss your treatment options with your caregivers. You can work with them to decide what care will be used to treat you. You always have the right to refuse treatment.
Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.
The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.