Lemon swabs for oral care? Opinions, please!`

**canoehead, BSN, RN** · May 31, 2004

Back about 10 years ago I read that they were found to cause drying of the mucus membranes, and from about then on the hospital got rid of them. We use sponge sticks now that are dipped in water, or a little ginger ale. For a major cleaning dip them in mouthwash.

caroladybelle, BSN, RN · May 31, 2004

Lemon swabs as well as mouthwashes/swabs with alcohol base to them are contraindicated in care of compromised patients. They serve to dry out the mucosal membranes. In many patients, they contribute to mucositis.

Swabs in ice water can be as refreshing as lemon based ones. Cancer patients typically rinse with NS (ocasionally with Baking Soda if needed to buffer it).

Mofe'ny · May 31, 2004

We don't use lemon swabs either. Normally just gauze and H2O then some Sweet-ese if it is a fussy kid.

Jolie, BSN · May 31, 2004

The lemon-glycerine swabs were removed from our unit eons ago by the skin care nurse. I vaguely remember her saying that they encouraged the growth of yeast in the mouth. I don't know if that was due to the drying effect they have on the oral mucosa, or whether the glycerine itself creates an environment that is favorable to yeast growth. I use sterile water for mouth care and surgi-lube for moistening lips. The key is doing oral care with every hands-on encounter, so that the mouth and lips never have a chance to get crusted.

Long Term Care Columnist / Guide · May 31, 2004

I hate the lemon-glycerine swabs........I remember how, after one or another of my surgeries, they dried my mouth out and made me thirstier than ever. To this day I offer my NPO and post-op patients a choice, but I always encourage use of the "toothettes" (little sponges dipped in water or other liquid of the patient's choice) and have found that most patients prefer them to the glycerine swabs.

JMHO :)

BittyBabyGrower, MSN, RN · Jun 1, 2004

We quit using those about 15 years ago. We only use the pink Toothettes in sterile water :)

prmenrs, RN · Jun 1, 2004

I wouldn't use toothettes or lemon swabs. Just suction their mouths if needed (for paralyzed babies). You can clean their mouths w/a gauze moistened w/sterile water. Use some vaseline to keep the lips moistened.

Lemon swabs are "tradition". I doubt there's any literature to support it's use, esp., for babies. You could probably do a lit search, if you wanted, but I would offer anyone who wanted to use one a taste first. That might change minds. Those things are NASTY!!

dawngloves, BSN, RN · Jun 1, 2004

Blah! I didn't like using those on adults! Our unit doesn't use those. We use sterile water and gauze on the ole' "lip crud".

Chad_KY_SRNA · Jun 1, 2004

We have both in our central supply closets. I like to try products we use on residents just once to see what we are using on them. The toothettes are far better than the lemon swabs. The lemon swabs are horrible. They will make you sick and dry your mouth out. The toothettes are far better as far as taste (mild mint taste) and ability to remove mucous buildup. LOL! Just thinking how gross this would sound to non-nursing folk.

suzanne4, RN · Jun 1, 2004

I thought that most hospitals did away with the lemon-glycerine swabs years ago.

NICU_Nurse, BSN, RN · Jun 1, 2004

Okay. Found this link: http://articles.findarticles.com/p/articles/mi_m0NUB/is_1_13/ai_112313472/print

Which has an article by the ***. of Critical Care Nurses (not specifically for babies, but a valid source, I think):

"Some solutions and types of equipment used by nurses for oral care are not optimal. Hydrogen peroxide and sodium bicarbonate effectively remove debris, but if not diluted carefully may cause superficial burns. Lemon and glycerine swabs stimulate production of saliva initially, but are acidic, causing irritation and decalcification of the teeth and rebound xerostomia."

Just in case anyone wanted hard evidence (like me!). Thanks! :)