It is crucial to prioritize the maintenance of hygiene, for patients as it serves two important purposes. Firstly it helps prevent the spread of germs and secondly it aids in speeding up their recovery process. There are patients who’re unable to take care of their oral hygiene on their own and require comprehensive assistance to ensure thorough care. As Certified Nursing Assistants your expertise in this field plays a role, in safeguarding the health and overall well being of patients.

Oral Hygiene Goals

  • Avoid cavities and infections or the aggravation of other injuries by eliminating bacterial plaque and food debris.
  • It is to avoid halitosis.
  • Avoid dry mouth and appearance of cracks, providing comfort.
  • Promote self-image and self-esteem.
  • Provide hygiene and well-being to the patient.

How to Brush a Patient’s Teeth

Supplies

  • Glass of water
  • Toothbrush
  • Oral antiseptic
  • Vaseline
  • Gauze
  • Forceps or Kocher to make swabs
  • Tongue depressor
  • Bat
  • Towel and soaker
  • Gloves

Execution

  • staff preparation
  • Ensure that all necessary material is on hand.
  • Hand hygiene.    
  • Putting on gloves.

Patient preparation

  • Patient identification.
  • Inform the patient and family of the procedure to be performed.
  • Encourage the collaboration of the patient according to their possibilities.
  • Preserve privacy and confidentiality.

Procedure

  1. Autonomous patient
  • If he is bedridden, place him in the appropriate position (supine and half-upright decubitus) whenever possible due to pathology or the patient’s condition and place a towel on his chest and on the pillow to protect him from splashing water.
  • Hygiene of the patient’s hands.  
  • Provide the patient with the necessary material (brush, toothpaste, glass of water or mouthwash, waste container) to carry out their own oral cleaning.
  • If the patient wears a removable prosthesis:
  • Remove the prosthesis, cleaning it with antiseptic before putting it back on.
  • Avoid maneuvers that may cause nausea to the patient.

2. For Conscious dependent patient

  • Brush the teeth from the gum to the crown, sweeping to remove debris.
  • Clean the external, internal, upper and lower face of the teeth and molars in both jaws as well as the tongue.
  • Provide a glass of water or oral antiseptic to rinse the mouth.
  • Apply Vaseline on the lips so that they are protected and hydrated.
  • Remove the material used in the indicated containers.
  • Remove the gloves.
  • Hand hygiene.

3. For unconscious dependent patient

  • Tilt the patient’s head to one side, if indicated.
  • Dip a swab in the antiseptic solution and wash the palate, tongue, inner face of the cheeks, gums and teeth.
  • If there are dry and stuck secretions, spread liquid Vaseline since it is difficult to remove without causing ulcerations in the mucous membranes.
  • Change the swab as many times as necessary.
  • Keep the mouth open using a tongue depressor, introduce water with a 10ml syringe, aspirating at the same time with a short tube with rounded edges. Repeat this operation with an oral antiseptic solution.
  • Wash the lips and perioral area with moist gauze.
  • Dry the lips well and apply Vaseline.
  • Place the patient in a comfortable position.
  • Remove the material used in the indicated containers.
  • Remove the gloves.
  • Hand hygiene.  
  • Repeat the technique, at least once per turn.

4. Removable dental prosthesis cleaning

  • Wash using a suitable brush.
  • Disinfect, immersing them for 10-15 minutes in an aqueous chlorhexidine solution (if the patient uses specific prepared products for dentures at home, we will use them whenever the patient or family member provides them).
  • Rinse with water before placement.
  • If not placed on the patient, dry and store in a denture container.
  • Remove the material used in the indicated containers.
  • Remove the gloves.
  • Hand hygiene.  

Special considerations

  • For patients who are intubated the procedure will be the same, as for patients who’re unconscious.
  • Check for any ulcers that may have been caused by injury or rubbing against the tube well as any traumatic or surgical wounds.
  • Assess the technique to be used for patients with ulcerations and/or surgical wounds.
  • If possible use floss for patients with overdentures.

Make sure to Record

  • Record the details, in the record.
  • Note down the procedure that was performed.
  • Sign and date the entry.
  • Include any incidents that occurred during the procedure.
  • Document how the patient responded to the procedure.