Assisting the Patient With Oral Care

Goal: The patient has a clean mouth and clean teeth, exhibits a positive body image, and verbalizes the importance of oral care.

1. Perform hand hygiene and put on gloves if assisting with oral care, and/or other PPE, if indicated.

2. Identify the patient. Explain procedure to the patient.

3. Assemble equipment on overbed table within patient’s reach.

4. Close the room door or curtains. Place the bed at an appropriate and comfortable working height; usually elbow height of the caregiver (VISN 8 Patient Safety
Center, 2009).

5. Lower side rail and assist patient to sitting position, if permitted, or turn patient onto side. Place towel across patient’s chest. Raise bed to a comfortable working position.

6. Encourage patient to brush own teeth, or assist, if necessary.
a. Moisten toothbrush and apply toothpaste to bristles.
b. Place brush at a 45-degree angle to gum line and brush from gum line to crown of each tooth. Brush outer and inner surfaces. Brush back and forth across biting
surface of each tooth.
c. Brush tongue gently with toothbrush.
d. Have patient rinse vigorously with water and spit into emesis basin. Repeat until clear. Suction may be used as an alternative for removal of fluid and secretions from mouth.

7. Assist patient to floss teeth, if appropriate:
a. Remove approximately 6 inches of dental floss from container or use a plastic floss holder. Wrap the floss around the index fingers, keeping about 1 to 1.5 inches
of floss taut between the fingers.
b. Insert floss gently between teeth, moving it back and forth downward to the gums.
c. Move the floss up and down, first on one side of a tooth and then on the side of the other tooth, until the surfaces are clean. Repeat in the spaces between all teeth.
d. Instruct patient to rinse mouth well with water after flossing.

8. Offer mouthwash if patient prefers.

9. Offer lip balm or petroleum jelly.

10. Remove equipment. Remove gloves and discard. Raise side rail and lower bed. Assist patient to a position of comfort.

11. Remove any other PPE, if used. Perform hand hygiene.