Mouth/Oral Care

Proper care of the mouth and teeth supports a client’s overall health and helps prevent mouth pain, eating difficulties, speech problems, digestive problems, tooth decay, gum disease, and even heart disease. Providing oral care can also promote a healthy appetite. For example, providing oral care before
breakfast can enhance the client’s ability to taste the food and enjoy the meal.

To help prevent decay and gum disease, teeth should be brushed twice daily with fluoride toothpaste if available. If fluoride toothpaste is unavailable, water and a soft-bristled toothbrush are sufficient. It is even better to brush after every meal. Teeth should be flossed at least once a day to clean between the teeth where the brush misses.

Watch for, document, and report any sore areas in the mouth, changes in tissue, complaints a client may have in eating comfortably, or anything unusual inside the client’s mouth. See Oral Health in the Resource Directory on page 343 for information on gum disease, dry mouth, and oral cancer.

The following are general tips when assisting a client with mouth care.

When assisting with brushing, use short, circular movements, gently brushing the teeth with a massaging motion around each tooth. Make sure to work in a pattern so no teeth are missed.
A soft bristle toothbrush is recommended by dentists and should be replaced when the bristles get worn (normally every three months).
Make sure you have good light and can see what you are doing.
Be careful not to touch the toothbrush bristles or any oral health item on other surfaces such as the counter, the sink, your bare hands, etc.
Do not contaminate faucets, drawer handles, or other surfaces by touching them with gloves that have been in contact with the client’s mouth.
If a client has difficulty grasping a toothbrush, make the handle bigger with a sponge, rubber ball, or adhesive tape. An electric toothbrush may be easier to manage than a manual brush in this case.
Toothettes, moistened gauze pads, or similar products may not clean the teeth completely and can push food further into the spaces between the teeth. These products are useful in cleaning mouth tissues when the client has no or just a few teeth, or for a client who is unable to open their mouth.

The following are general tips when assisting a client with flossing.

Start with a strand of dental floss approximately 18 inches long.
Use a pre-threaded flosser or floss holder (a great assistive device), or wrap the floss around the middle finger of both hands.
Use your thumbs and forefingers to control the floss.
Gently ease the floss between the client’s teeth using a gentle back-and-forth motion.
Carefully rub up and down, gently moving the floss from under the gum line to the top of the tooth. Keep the floss against the tooth so you don’t injure the gums.
If a client has not flossed before or recently, the gums may bleed when you floss. If the client has heavy deposits on their teeth, it may be difficult to get the floss between their teeth.