The Importance of Oral Care

1. What we Know
a. A person’s ability to eat
b. Diet
c. Speech
d. Hydration
e. Weight
f. Appearance
g. Behavior
h. Social interactions
i. Quality of life
2. What Should and Shouldn’t be Used
a. Small, soft-bristled toothbrushes
b. Chlorhexidine oral rinse (found at dentist office), or normal saline (found to be more
effective than commercial mouthwashes for rinsing)
c. Include the use of water during oral care
d. Should not use lemon or glycerine swabs (the can cause drying effects on the oral
mucous membranes)
3. How frequently
a. Care professionals should perform oral care on patients:
i. Every 4 hours or at least after meals
ii.Every 2 hours in the ICU
iii.Every 2 hours for intubated patients and patients with a tracheostomy
iv.Provide moisture to the mouth orally for patients on oxygen or with dry mucous
membranes
v.Dentures should be soaked for 10 minutes every day

Periodontal Disease

1. Warning signs
a. Bad breath or taste that won’t go away
b. Red, tender, bleeding or swollen gums
c. Painful chewing
d. Loose or sensitive teeth
e. Gums that have pulled away from your teeth
f. Any change in the way your teeth fit together when you bite
g. Any change in the fit of partial dentures
2. Risk Factors
a. Smoking
b. Diabetes
c. Poor oral hygiene
d. Stress
e. Heredity
f. Crooked teeth
 g. Underlying immuno-deficiencies
h. Taking medications that cause dry mouth
i. Female hormonal changes
3. Complications (research suggests that the bacteria responsible for periodontitis can travel
through your bloodstream, affecting many parts of your body)
a. Tooth loss
b. Coronary artery disease
i. bacteria may travel to the arteries in your heart. There, they can trigger a cycle
of inflammation and arterial narrowing that contributes to heart attacks
ii.the American Heart Association (AHA) recommends that people with certain
heart conditions take antibiotics before dental treatment to avoid a bacterial
infection of the heart or heart valves (endocarditis)
c. Stroke
d. Low birth weight babies
e. Poorly controlled diabetes
i. Poor oral care can lead to more infections, making it harder to control blood
sugar
ii.High blood sugar levels give mouth bacteria more food, increasing the infection
rate
f. Respiratory problems
i. bacteria can travel to the lungs, causing infection or aggravating existing lung
conditions
ii.bacteria can travel into the lower respiratory tract and lungs, causing an
infection or making an existing condition worse such as COPD
g. Ventilator-associated pneumonia (VAP)
i. The microorganisms in the mouth translocate and colonize the lung
4. Treatment and prevention
a. Brush (at a 45 degree angle to your teeth) and floss every day
b. Eat a healthy diet
i. Limit sugars, chewy candy, dried fruit and bananas (food that sticks to your
teeth)
c. See a dentist at least once a year, or more frequently if you have any of the warning
signs or risk factors
5. Need help?
a. The Health Resources and Services Administration supports a network of "safety net"
clinics for people who qualify for reduced-cost care, and many have a dental clinic (toll
free: 1-888-275-4772).
b. Many dental schools have a clinic staffed by the professors and students, where care is
provided based on your ability to pay.
c. Your state dental organization may be able to refer you to dentists in your area who
provide care at a reduced rate.

Oral Care in the Older Adult

1. Good oral care allows a person to:

 a. Stay pain free
b. Eat and talk comfortably
c. Feel happy with their appearance
d. Maintain social interaction
e. Stay as healthy as possible
f. Maintain self-esteem and health care habits and standards they have had throughout
their life
2. Plaque can cause aspiration pneumonia
a. Inflammation of the lung and bronchi caused by inhaling or choking on vomit
3. Much of a patients care is medical care and nursing care, sometimes the oral health needs are
overlooked
4. An oral health assessment should be done at admission with the full assessment and
periodically throughout the patients stay
References

Oral Care of the Hospitalized Patient http://web.ebscohost.com/ehost/pdf?

vid=1&hid=6&sid=4947d686-7374-48e1-863f-6f69ec63879d%40sessionmgr14

Improving the oral health of older adults with dementia/cognitive impairment living in a
residential aged care facility
http://web.ebscohost.com/ehost/pdf?vid=1&hid=6&sid=2d270740-92c7-4312-9fa7-
de8c7a7303a5%40sessionmgr10

ICU Nurses’ Oral-Care Practices and the Current Best Evidence

http://web.ebscohost.com/ehost/pdf?vid=14&hid=6&sid=8ac3d6a1-34f9-42bf-8037-
18268c75cc48%40sessionmgr11

Evidence-Based Protocol
Oral Hygiene Care for Functionally Dependent and Cognitively Impaired Older Adults
http://web.ebscohost.com/ehost/pdf?vid=1&hid=6&sid=9cfaedb6-38dc-414c-8cf6-
149d7151b659%40sessionmgr14

Oral Care in the Critically Ill

http://web.ebscohost.com/ehost/pdf?vid=1&hid=6&sid=800425ed-b8ca-4b6a-b99a-
3333fa1e3a56%40sessionmgr4

NURSING HOME ORAL HEALTH CARE

http://www.dentalgentlecare.com/nursing_home.htm

Dental care and chronic conditions

https://www.bcbsri.com/BCBSRIWeb/pdf/MM-3869%20Dental_June%202007.pdf

CDC
http://www.cdc.gov/OralHealth/topics/periodontal_disease.htm

ADA.org
http://www.ada.org/

mayoclinic.com
http://www.mayoclinic.com/health/periodontitis/DS00369