Nursing assistants need to provide oral care to intensive care patients who are unconscious or unable to eat, drink or clean their mouth without assistance. Proper oral care helps prevent infections and other oral problems. Oral care management involves using appropriate oral care equipment and providing proper oral care periodically. For instance, materials such as pediatric toothbrushes, sponge-stick, oral aspiration tools, tongue depressor, and sterilized water are used to keep the patient’s mouth clean, hydrated and free from microorganisms.
Oral care procedures are different for the conscious and the unconscious patient. For the conscious patient, the nursing assistant should perform the following actions:
- Inform the patient about oral care so that the patient can assist in the care process.
- Perform hand hygiene and wear gloves. Raise the patient’s head and cover the chest with a towel.
- Use a pediatric toothbrush and a small amount of toothpaste to clean the patient’s teeth, gums and tongue.
- When brushing, note any signs of bleeding or infection in the patient’s mouth. If any lesions or abscesses are seen, report immediately to the supervisor so that appropriate treatment can be provided.
- After brushing, help the patient take small amounts of water into the mouth to remove the toothpaste.
- Place the patient back onto the bed.
If the patient is using dentures, ensure that these false teeth are also brushed and cleaned properly with warm water. Dentures should be rinsed and placed in a container stating the patient’s name, to prevent loss or damage.
For the unconscious patient or the patient associated with a mechanic ventilator, the nursing assistant uses a tongue depressor so that the mouth is clearly visible for cleansing and moisturizing. Next, a pediatric toothbrush is used to brush the teeth and gums. The patient’s head is turned to one side so that saliva and toothpaste are not aspirated. After brushing, the nursing assistant has to suction the remaining toothpaste as the patient cannot clean himself. Once the patient’s mouth is cleaned properly, the nursing assistant places him/her back on the bed in a comfortable position.
To avoid bad breath, and the growth of bacteria in the mouth, tooth brushing should be done at least twice daily.