Providing Oral Care for the Dependent Patient

Goal: The patient has a clean mouth and clean teeth; is free from impaired oral mucous membranes; demonstrates improvement in body image; and verbalizes, if able, an understanding about the importance of oral care.

1. Perform hand hygiene and put on PPE, if indicated.

2. Identify the patient. Explain procedure to patient.

3. Assemble equipment on overbed table within 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). Lower one side rail and position patient on the side, with head tilted forward. Place towel across patient’s chest and emesis basin in position under chin. Put on gloves.

5. Gently open the patient’s mouth by applying pressure to lower jaw at the front of the mouth. Remove dentures, if present. (Refer to Skill 7-4.) Brush the teeth and gums carefully with toothbrush and paste. Lightly brush the tongue.

6. Use toothette dipped in water to rinse the oral cavity. If desired, insert the rubber tip of the irrigating syringe into patient’s mouth and rinse gently with a small amount of water. Position patient’s head to allow for return of water or use suction apparatus to remove the water from oral cavity.

7. Clean the dentures before replacing. (See Skill 7-4.)

8. Apply lubricant to patient’s lips.

9. Remove equipment and return patient to a position of comfort. Remove your gloves. Raise side rail and lower bed.

10. Remove additional PPE, if used. Perform hand hygiene.