Mouth crud - page 2

Ok this is a random thread but the more I work in the hospital, the more I notice that patients don't get proper mouth care, especially the total care patients. I'm having a hard time figuring out... Read More

  1. Visit  Sugarcoma profile page
    12
    Mouth crud...I HATE mouth crud. The only other substance that frustrates me more is the soap scum film on my shower door. What exactly happens to bodily secretions that causes them to morph into an indestructible film? So frustrating.

    I use a variety of methods to attack it. For around the mouth I apply a liberal amount of water based lubricant and allow it to soak on for a little while. I then use either 4x4's or a washcloth soaked in warm water and gently wipe. Repeat multiple times per shift until all the globs of gunk are gone.

    For inside the mouth I use liberal amounts of Peridex and warm water. I start with warm water on a toothette and just gently wipe the areas that are the most filmy trying to soften it up. I then use the peridex and a yankur. Repeat multiple times per shift.

    My patients are mostly sedated so this allows me to scrub vigorously. Just remember to be gentle and never pull anything off you have to kind of soak it off.

    I once removed a completely intact film from a patient's mouth that looked like a mold of the roof of his mouth. Took me almost all shift. It was oddly satisfying. Sometimes I wonder about myself lol.
    VioletKaliLPN, silverbat, emcadams, and 9 others like this.
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  3. Visit  Sugarcoma profile page
    0
    Quote from sbostonRN
    We have these toothbrushes that attach to the wall suction. They are soft plastic. They work great for those at risk for aspirating secretions and oral care products! They are made by Kimberly Clark.
    I am so jealous!!!! I want these!!!!!
  4. Visit  xoemmylouox profile page
    1
    Quote from sbostonRN
    We have these toothbrushes that attach to the wall suction. They are soft plastic. They work great for those at risk for aspirating secretions and oral care products! They are made by Kimberly Clark.
    These worked well while my father was in the hospital. He was intubated and he had lots of mouth junk. It removed most of the nasty stuff and prevented him from aspirating on the liquids.
    Sugarcoma likes this.
  5. Visit  OnlybyHisgraceRN profile page
    5
    I come from ICU and most of our patients had beautiful mouths. We had to use cholrexidine swabs every 4 hours for intubated patients and q8h for non-intubated patients. It worked wonders.
  6. Visit  GrnTea profile page
    3
    Quote from OnlybyHisgraceRN
    I come from ICU and most of our patients had beautiful mouths. We had to use cholrexidine swabs every 4 hours for intubated patients and q8h for non-intubated patients. It worked wonders.
    I believe this is also becoming standard of care for decreasing the risk of HAP-- hospital-acquired pneumonia. Decreases the bacterial load in the oropharynx so fewer pathogens in the inevitable bits that slip down the side of the tube (balloon or no balloon).
  7. Visit  Esme12 profile page
    1
    mix cholrexidine and hydrogen peroxide....does wonders.
    Sugarcoma likes this.
  8. Visit  SwansonRN profile page
    0
    Chlorahexidine, toothettes, Vaseline to the lips. Always. If they have teeth and have the capability I will help them brush plus rinse with non alcoholic (that sounds weird) mouthwash. Hate smelly icky mouths.
  9. Visit  SoldierNurse22 profile page
    1
    OP, if I were you, I'd pull together the info you've got here, do some research of your own and make an inservice for your ward. The inservice doesn't have to be anything fancy. In my workplace, our inservices often come in the forms of fliers with easy to understand, quick pointers on how to improve an aspect of patient care or nursing practice. Nurses and CNAs alike can benefit from re-learning or being reminded about how to do proper oral care.

    It is commendable that you are concerned about this enough to want to improve your practice, but I'd challenge you to take it a step further--see if you can't spread that good practice beyond your care and influence the care of your coworkers. That's how you'll see real improvements for your patients and your ward.
    amoLucia likes this.
  10. Visit  Glycerine82 profile page
    1
    We use an oral debreeding agent witht he mouth swabs it works great. It comes in a pack with the swabs and mouthwash minus the alcohol. Soak the swab and rub it over the lips let it sit a minute same with the inside just keep going over the inside of he cheeks.

    "No day but today"
    Sugarcoma likes this.
  11. Visit  1Dreamer profile page
    1
    I find that a green or pink mouth swab soaked in coke a cola will loosen bad crud.
    Sugarcoma likes this.
  12. Visit  liveyourlife747 profile page
    1
    Quote from Sugarcoma

    I once removed a completely intact film from a patient's mouth that looked like a mold of the roof of his mouth. Took me almost all shift. It was oddly satisfying. Sometimes I wonder about myself lol.
    This is how I would feel if I could've gotten the crud out! We would probably get along.

    And to everyone else, thanks for the tips!!
    Sugarcoma likes this.
  13. Visit  amoLucia profile page
    3
    Mouth crud as described here is sad. I can see an occasional ommitted shift here & there because yes, things do get hectic. But to have developed so badly shift after shift after shift is hard to explain. To NOT try to clean it when so obvious....

    I also equate unshaven mens' faces on the same level of care. When they've days & days of growth to the point that they look wildmen, that's sad too. But that's another thread.
    RNperdiem, sharpeimom, and Sugarcoma like this.
  14. Visit  Nursetastic profile page
    2
    4X4's or a washcloth soaked in warm water and oral lubricant, then wrapped aroung a tongue depressor. Gently wipe the entire oral cavity with a yankauer close at hand. Do this a few times per shift and most gunk should come right out. I've also been known to use a hemostat to pluck the loosened pieces out of the mouth...they clog the yankauer otherwise.
    Sugarcoma and SNB1014 like this.


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