Mouth Care

CoffeemateCNA · Apr 28, 2011

There's so much to get done, that a lot of people just don't bother, especially when/if oral care supplies are scare. I try to do oral care on everyone that I can, but I honestly can't say that I do oral care on every person, every day. There are people that fight oral care, and others that flat-out refuse.

I do make an effort to do good oral care on bed-bound hospice residents, who are often "mouth-breathers." And I do at the very least swab/mouthwash other people's mouths, or actually brush with toothbrush and toothpaste if they let me.

Kitsey · Apr 28, 2011

Thank you Coffeemate, I didn't consider the fact that the CNAs I was following already know which residents will allow the care or not. I'll bet that's probably why a lot of people got skipped over :) I didn't encounter any bed-bound hospice care residents, but I will remember your tip when I do :)

LaterAlligator · Apr 28, 2011

I work eve shifts and do oral care on 90% of my residents. I work in dementia so I know there are a few that will get combative if I even try, so I settle for washing their faces only. But I hate never-brushed breath, and get worried that the ones with dentures will get sores in their mouths from keeping them in, so I generally end up taking the ass-kicking from them so I can remove their dentures. I've gotten really fast at it!

Dorali, BSN, LPN, RN · Apr 28, 2011

I will admit that I am one of the ones that doesn't do much oral care. And yes, I am ashamed of that because I don't leave my house without brushing my own teeth.

I work day shift and I think the problem is the time constraits. There are 7 CNAs on my shift and one is shower aide, so 6 working the floor. I actually counted this morning and we have about 40 people to get up for breakfast. Our shift starts at 6 and everyone has to be dressed and to the dining room by 7:30. Everyday, I do brush dentures because I can't stand to see them gross and I couldn't imagine having to taste the cleansing tablets. As for actually brushing the inside of their mouth, that just doesn't happen very often. I wish the ratios were smaller so I could give the kind of care I WANT to give rather than what tine allows.

karamarie91 · Apr 29, 2011

Today was my first day of orientation at my first CNA job and I too was surprised by the lack of mouth care given at the facility. My preceptor is so dedicated to the residents, however, that she says," I try to brush their teeth because I can't have my residents walking around with sticky breath!" There is so much going on during 7-3 that many important ADLs such as nail care just dont get done. I'm hoping that when I get my own assignment that I can keep everyone safe and clean from head to toe.

If I was a resident, I would want that....

yousoldtheworld · Apr 29, 2011

I think some people just don't want to do anything they can avoid doing, while others (and probably the majority) are just trying to do what they CAN while working a really, really busy job. I won't say I've always been able to do good oral care on every single resident. I try to, and most days they do all get their teeth brushed at least once by me.

I have worked with people who do the absolute bare minimum, and that is really frustrating. But I just try to tell myself that they're in the minority.

sm3215 · Apr 30, 2011

Unfortunately mouth care is often forgotten/left out for time. I at least attempt mouth care on every resident when I'm working LTC. Honestly, it only takes a minute and it really is important for their health. You should try, even if you think someone won't let you, then at least you made the attempt.

fuzzywuzzy, CNA · May 1, 2011

I don't get why so many people are dead set against mouth care. If I had the choice between not showering for a month and not brushing my teeth for a month I would choose to keep brushing my teeth. But even the alert residents seem to want nothing to do with it.

yousoldtheworld · May 1, 2011

It's a mystery to me, too. Even the kids I take care of who are unable to talk and generally smile their way through baths, showers, etc will clamp their mouths shut at tooth brushing time.

supervisorhatchet · Sep 9, 2011

Mouth care is one of my pet peeves. It takes about 15 seconds to do oral care on a resident that is edentulous...If it has been done routinely.

as a new CNA please get in the habit of doing things the right way. As charge nurse, educator and RN supervisor, I would much rather see a CNA do things the right way, even if that means you are running behind.

As a night nurse, as we did bedside rounding, I always checked resident's that were resistant to care, (because some people use "refused" as an excuse not to do their work), I checked to see if all dentures were out, in there cups, I checked every mouth of every tube feeder, O2 user, and mouth breather at the beginning of my shift to check if done with PM care by previous shift. And during my shift, I checked every time I did a med pass, I checked briefs, faces, hand and mouths.

There is a big difference in what a resident looks like when the CNA doing all :up:she/he can do:rolleyes: and when he/she is doing as little:down: as she/he can do. :confused:

If mouth care has not been getting done routinely, some residents will be resistant at first. For those mouth breathers, tube feeders, and continous O2 users mouth care is supposed to be done EVERY 2 hours. :eek: And for everyone else, with AM & PM care at the very least and more often if possible.

Good luck to you. Being a CNA is a very hard job. But is even more REWARDING, :yeah:esp when you do things right. Your resident's will trust you,:redpinkhe and be more cooperative to care (thus your job is easier) when they realize that you are looking out for there best interest. :nurse:

northernguy · Sep 10, 2011

I usually do oral care on all the people I have. I might make an exception if they are someone who is combative or totally uncooperative and attempting it is going to really stress them out and eat up a lot of time. Even then I dont make a habit of skipping it.

People have been written up where I work for not doing it, and there are aides who report it if its not being done, which I dont have a problem with really. Im amazed its apparently something aides at other facilities skip a lot. I do work in a VERY strict facility though, and its the only place Ive worked in LTC. I did my CNA clinicals in another facility and I remember before attempting it on one resident I asked an aide who worked there if this guy was gonna try to bite my fingers off, and they just looked at me and shrugged, as if attempting it had never even occured to them.