Sunday, December 18, 2011

Care of the Mouth




DEFINITION:
The care given to the mouth of a sick person.

PURPOSE:
1.  To maintain good condition of the mouth and teeth.
2.  To prevent the spread of disease, increase appetite and comfort of the patient.
3.  To prevent sores and mucous ulcerations.
4.  To foster habits of personal hygiene.
5.  To maintain general health and vitality of the body.
6.  To strengthen self-respect with the feeling of cleanliness.

THINGS NEEDED:
1. For bed patient:
a)  Toothbrush (with soft bristles) and toothpaste.
b)  Glass of water.
c)  Small basin or small can.
d)  Towel.
e)  Tissue paper.
f)  Straws.
2.   For helpless patient:

a)  Cotton applicators (long size).
b)  Normal saline solutions or water with 1/2 tsp. of salt to 1/2liter of water (2 glasses)
c)  Hydrogen peroxide.
d)  Tongue depressor or padded tongue blade or padded spoon handle.
e)  Newspaper for used applicators.
f)   Mineral oil or coconut oil.
g)  Towel.
h)  Tissue paper.
i)   Flashlight (optional, if done at night).

PROCEDURE:
1.            For bed patient:
a)  Wash hands before starting the procedure.
b)  Assemble all things needed.
c)  Put patient in high back rest position with head and back supported with pillows. Turn head to side and place basin under the- side of the jaw. 

If the high back rest position is inconvenient, put patient in a side lying position.  Place patient's head on edge of pillow, facing you.
d)  Put towel under the chin and over chest and
                shoulders.
e)  Moisten toothbrush and put on toothpaste.

f)  Instruct patient to open mouth depending on which part is being cleansed.
                g)  Brush teeth as follows:
1) Brush the upper teeth, inside and outside in a downward motion.
2) Brush the lower teeth inside and outside in an upward motion.
3) Use circular motion on the flat chewing or grinding and cutting surfaces.
4) Brush tongue as far as the patient can tolerate.
5) Massage gums gently with the use of brush, taking care not to cause injury.
6) Let patient rinse mouth. instruct patient to let solution flow out into the basin rather than spit it out.  (Straw may be used if patient is unable to drink from the glass.)
7) Repeat procedure if mouth is still dirty.
8) Rinse mouth thoroughly.
9) Wipe mouth with tissue.
10) Wash hands thoroughly specially after caring for contagious patients.

2.   For helpless and unconscious patients:
                1) Wash hands before starting the procedure.
2) Have all things ready at bedside.
3)  Place towel under chin, over chest and shoulders of patient.
4)  Turn patient's head toward you.
5)  Open patient's mouth with the depressor or with the padded spoon handle, as mouth gag.
6)  Use hydrogen peroxide for cleaning. Dip applicator in solution. Press swab against side of container to squeeze out excess fluid.
7)  Clean mouth as follows:
a) Sponge outer and inner surfaces of upper and lower teeth, gums, and chewing surfaces.
b) With rotating motion cleanse the palate.
c) Clean the inner cheeks.  Rinse and massage gums  with  gauze  or cotton,  moistened with hydrogen peroxide.
8)  Clean one part of the mouth at a time. Replace applicator with a fresh one for each part and continueuntil all areas are cleaned.
9)  Use normal saline solution or salt solution to rinse after each part is cleansed.
10)Hydrogen peroxide removes decaying food by its bubbling action, reduces bacterial activity, and thus prevents dental caries and halitosis.

PRECAUTIONS:

 1.   Applicators must be moist, not wet, so that solution will not pool in the mouth. Food particles left must be removed by sponging.
2.   Fingers should never be put. in patient's mouth because the gag or hold in the jaw may be. loosened and the jaws might close down on the fingers. Human bites can cause
severe infections.






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