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Oral hygiene for bedridden pt

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by Lee_Ryan Lee_Ryan (New) New

Hello,

I'm a student and I have question about patient's oral hygiene i hope any of the members here can help. So, we had a 90y.o granny, who recently had an abdominal surgery. She is obese, bedridden and has drains coming out of her stomach. On my last day of practice, i helped her with her meal i noticed her mouth was dirty with food-stuff (mainly yoghurt). She doesn't communicate well and i don't think she can spit, not to mention gargle. She doesn't have much teeth left, so how would you clean her mouth and do it efficiently?

I know this is very basic skill, but i would like to learn how to do this without taking so much time, I believe i will meet this type of client again in the future. Do you think that lemon-swabs are good enough?

Any tips are welcome :) Thank you, Ryan.

Double-Helix, BSN, RN

Specializes in PICU, Sedation/Radiology, PACU. Has 10 years experience.

Can she swallow? You can brush her teeth with a safe-to-swallow toothpaste. Or turn her on her side, brush her teeth and use a suction catheter to suck out the extra liquid- similar to what the dentist does. Have you ever used a lemon swab on yourself? Try it one day and then let me know whether you think it's equivalent to brushing your teeth.

The soft swabs you were referring to sound like the best option for her. Try taking a 10 CC syringe and attaching just the catheter (not the needle) from a 18-22 gauge IV to make your own "water pick" that you can help to clean her mouth.

Double-Helix is correct though, we would need a bit more information to tell you how to safely care for her. Her being conscious enough to swallow and protect her airway is very important in this discussion.

We use the Royal Marsden Hospital Manual of Nursing procedures in Britain, and that is our guide to many, if not all our nursing procedures. Mouth care can be difficult sometimes, but, if your patient is able to swallow, (as I think she is as you were helping her with her meal) then I would suggest using a small baby/young child tooth brush, and toothpaste. Get the patient to do it if they can. Brush the teeth as you would, being sure to cover all the teeth, if the patient can rinse their own mouth, then ask them to do this after providing them with a drink and a spit bowl, otherwise use a wet mouth sponge,and gently clean out the toothpaste and food debris. Toothpaste is a lot nicer than lemon soaked sponges, eww! Also, Plain Soda water can be used to refresh the mouth after meals.