Oral care

[Michigan]

Working LTC. Have a patient with very bad dry mouth and crusting. NPO with feeding, dysphagia. Any suggestions for cleaning mouth and help to keep it moist. I remember using a product years ago that worked very well but can not remember the name. Currently using oral swabs and mouthwash, lemon glycerin too drying. Thanks

[ktwlpn, LPN]

We've used a little light olive or veg oil on a swab after frequent mouth care with good results...

[Inquisitive one]

You could mix mineral oil and alcohol free mouth wash 1:1 ratio and swab with toothette every 2 hours. Sometimes we add hydrogen peroxide in the same ratio. There's a product called OASIS that I believe is over the counter.

[RN1982]

There is a moisturizing mouth spray, I can't remember what the name is though. It worked. If someone's mouth is that dry, that's terrible. Just gives me the impression that no one except you has bothered to clean the patient's mouth.

[RDH1, ADN, BSN, RN]

Hi. I'm a registered dental hygienist who is in nursing school. I recommend Oasis to my dental patients who have dry mouth. It is OTC. They also make a spray I believe. Also, there is a product called MI paste- it is not OTC but it works great for dry mouth! It is like a cream for the teeth- not toothpaste. GC America makes it. They also make a dry-mouth product, but that is not OTC either.

Another product is Biotene. It is OTC and comes in mouthwash or spray forms.

What about a saliva-substitute spray like Salivert? The doc may need to prescribe that.

Try to avoid any mouthwash with alcohol in it as it is very drying. Crest Pro Health rinse is alcohol-free, Listerine is not. I would also avoid mixing peroxide with anything as that has also been known to dry the mouth further.

Hope this helped a little bit!!

[texastaz]

I use to use a mouth moisturizer in a little white tube - don't remember the name either. I tried it once myself because my hospice patients would jerk their face away or close their mouth when I used it - so I tasted it myself. It was a very strong mint taste and actualy so strong it stung in my mouth - then I started to dilute it with water when I used it(maybe that is why it isn't around anymore). I haven't seen it over the past year. The Lemon work better and don't taste bad. I have had NPO patients who have told me they like them. To bad there isn't muliple flavors available!

[catshowlady]

I think the mouth moisturizer is made by Sage. The tube just says, "mouth moisturizer" on it, no brand name that I know of. I will say, that stuff is awesome for softening the dried-on crud. We follow up with Sage cleaning swabs - I think they are peroxide-based. It comes in a kit. We use them for vented pts, and I will break one out for those NPO pts with dry mouth like yours. They are not especially cheap; however, I'm sure you can buy the mouth moisturizer separately, as we stock it that way too. I have used a 50-50 mixture of mouthwash (we only carry alcohol-free) and water in a pinch.

If nothing else, you could probably use only a tube or two of the mouth moisturizer until you get the pt's mouth in better shape, then I would also wonder about switching to the artificial saliva.

[MobileNurseSara]

Equal parts alcohol-free mouthwash, heavy mineral oil, and peroxide. We called it the "palliative cocktail" at my old work because it worked so well for our palliative residents with super dry mouth.

[Michigan]

Thanks for all the help. We will be ordering some ofthe sage and another moisturzing agent. Agree mineral oil works well, but concerned with aspriation pneumonia- RS was admitted with asp. pneumonia and mineral oil can cause a nasty pneumonia, but I see many reccomendations for it??? Maybe for people without swallow problems? Again thanks for your help.