‘International Nurses Day is an opportunity for everyone to celebrate nurses’

Maintaining a clean and comfortable oral cavity helps patients to recover and reduces the risk of their health declining. They will be able to communicate better, eat more easily and will maintain dignity.

Gail P. Mooney, MSc, PG Social Research Methods, RGN, lecturer, School of Health Science, University of Wales, Swansea.

First explain to the patient what you are going to do. Examine the patient’s mouth wearing gloves and an apron. Use a torch to help you see into the back of the patient’s mouth. If applicable move the patient’s dentures. Use the RMB Assessment tool (Rattenbury et al, 1999).

The most effective aid for maintaining dental and gingival health is a toothbrush (Pearson and Hutton, 2002).

Note: if gums bleed its because plaque has previously been allowed to build up. If they are inflamed do not avoid brushing the gum. The gums may bleed because plaque has previously been allowed to build up. Proceed to clean the gums gently. If there is excessive bleeding from the gums report to the doctor. There may be an underlying medical problem e.g. clotting disorder

Dilute one teaspoon in 500mls of warm water

When tenacious mucous is present or mouth is crusted

1 tablet to a beaker of water

Useful for refreshing mouth, plays no part in cleaning. Effect lasts 20 seconds

Rinse the mouth with 10mls for about one minute twice a daily

Highly recommended, inhibits bacterial growth

100,000 units four times daily after food, usually for seven to nine days

If patient wears false teeth, remove before introducing

Use small amount on toothbrush

Refreshing - ideal pH of seven

Tinned variety tolerated better than fresh

Ideal for dry mouths, contains a proteolytic enzyme ananse that cleans the mouth

Prevents lips cracking, easy to apply flavoured balms available

There is little research to support the frequency by which oral hygiene should be carried out. Using an assessment tool will give some indication of how often the oral cavity should be cleaned. Patient comfort and the state of the oral cavity should govern the frequency of oral care. The assessment tool will allow you to make an accurate assessment and will help to identify and plan nursing interventions.

Rattenbury, N. et al (1999) Oral assessment and care for inpatients. Nursing Times; 95: 49, 52-53.

Pearson, L.S., Hutton , J.L. (2002) A controlled trial to compare the ability of foam swabs and toothbrushes to remove dental plaque. Journal of Advanced Nursing; 39: 5, 480-489.

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