ORAL HYGIENE

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ORAL CARE FOR PATIENTS

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PRESENTED BY MR.GIBIN SUNNY ASST.LECTURER NUINS .CON: 

PRESENTED BY MR.GIBIN SUNNY ASST.LECTURER NUINS .CON ORAL HYGIENE

ANATOMY OF MOUTH: 

ANATOMY OF MOUTH The oral cavity is divided into an outer smaller portion called vestibule and inner larger part called oral cavity proper VESTIBULE It is a narrow space bounded externally by lips and cheeks and internally by gums and teeth. ORAL CAVITY PROPER It is bounded anterolaterally by the teeth, gums and alveolar arches of jaws. The roof is formed by hard and soft palates, which separate it from the nasalcavity.Floor is formed by the dorsum of the tongue ,and anteriorly by the sublingual region

GUMS, TEETH AND TONGUE: 

GUMS, TEETH AND TONGUE GUMS Gums are soft tissues, which envelop the alveolar processes of the upper and lower jaws. TEETH AND TONGUE It forms a part of the masticatory apparatus and are fixed to the jaws. The teeth of first set is known as milk teeth or deciduous teeth and second set as permanent teeth. Permanent teeth are 32 in number(8 incisors,4canines, 8 premolars, 12 molars).Each teeth has three parts-crown(projecting beyond the gum)crown covered by a layer of enamel .it is the hardest substance in the body , root(embedded in the jaw),neck(between the crown and teeth).Tongue is a muscular organ situated in the floor of the oral cavity and oropharynx.

MEANING OF ORAL HYGIENE: 

MEANING OF ORAL HYGIENE Oral hygiene means the cleanliness of the mouth. Oral hygiene include the measures to prevent the spread of disease from the mouth and increase the comfort of the patient.

OBJECTIVES: 

OBJECTIVES To keep the mouth and teeth in good condition To prevent the mucous membrane from becoming dry and cracked To prevent sores which resulting in ulceration To prevent bacteria in the mouth from causing local and general infection

SCIENTIFIC PRINCIPLES: 

SCIENTIFIC PRINCIPLES Any new treatment or exposure to unfamiliar situation produce worry,anxiety,fear etc . Food particles left in the mouth promote the growth of microorganism Soap which is a constituent of most dentifrices has a low surface tension and spreads easily and penetrates in between teeth. Cold water reduces friction and hot water destroys the dentrifices

SCIENTIFIC PRINCIPLES: 

SCIENTIFIC PRINCIPLES Cough reflex is depressed in unconscious patients Giving mouth care provides opportunity to observe the condition of mouth and teeth. Knowledge about the technique of keeping the mouth healthy helps in practicing it and maintains health.

SCIENTIFIC PRINCIPLES: 

SCIENTIFIC PRINCIPLES A clean mouth and teeth aids to the patient the feeling of self approval. Emollients help to soften the dry mucous membrane to prevent cracking. Patient comfort and safety may be enhanced by practice of good technique, which provides economy of time, materials and energy

IMPORTANCE OF MOUTH CARE: 

IMPORTANCE OF MOUTH CARE The mouth is one of the chief portal entry of disease by bacteria & it is an ideal incubator for germs. It is the entry of both respiratory and alimentary tract. Care of mouth and teeth prevent tooth decay, gum disease, parotid gland infection and mouth sores. Mechanical cleansing and forceful rinsing is important to get rid of food particles from around teeth and gum.

IMPORTANCE OF MOUTH CARE: 

IMPORTANCE OF MOUTH CARE Cleaning of mouth give great comfort and relief to client. It also help to prevent bad taste and odors of mouth. Clean mouth has a good effect for appetite and digestion.

PATIENT WHO NEEDS SPECIAL MOUTH CARE: 

PATIENT WHO NEEDS SPECIAL MOUTH CARE Mouth care is much important during illness.-high temprature,mouth breathing,malnutrion and other condition accompanying illness cause drying and cracking of lips.

PATIENT WHO NEEDS SPECIAL MOUTH CARE: 

PATIENT WHO NEEDS SPECIAL MOUTH CARE IN SICKNESS PATIENT NEED SPECIAL CARE IF: Patient seriously ill Unconscious patient Patient with fever and patient breathing through mouth

PATIENT WHO NEEDS SPECIAL MOUTH CARE: 

PATIENT WHO NEEDS SPECIAL MOUTH CARE Patient who are on liquid diet Post operative patient, paralyzed patient Patient on tube feeding,gastrostomy feeding If patient with heavy sedation or under anesthesia for prolonged period

PREPARATION OF ARTICLES FOR UNCONSCIOUS OR SPECIAL CARE PATIENT: 

PREPARATION OF ARTICLES FOR UNCONSCIOUS OR SPECIAL CARE PATIENT ARTICLES A tray consist of Mackintosh and towel Small jug with warm water Feeding cup Small bowel(2) PURPOSE To protect the bed and dress of client To give a gargle to patient To pour water or solution in mouth for lying patient One for gauze piece or cotton and other for keeping the paste for cleaning the mouth

PREPARATION OF ARTICLES FOR UNCONSCIOUS OR SPECIAL CARE PATIENT: 

PREPARATION OF ARTICLES FOR UNCONSCIOUS OR SPECIAL CARE PATIENT ARTICLES Artery forceps(1) Dissecting forceps(1) Small container Paper bag Kidney tray PURPOSE To hold the rag piece or to hold cotton to clean teeth To remove the used the swab from the artery forceps To keep the dentifrice To keep used swab To receive waste water

PREPARATION OF ARTICLES FOR UNCONSCIOUS OR SPECIAL CARE PATIENT: 

PREPARATION OF ARTICLES FOR UNCONSCIOUS OR SPECIAL CARE PATIENT ARTICLES Small bowl(2) Cotton applicator Face towel and warm water in bowel PURPOSE To keep mouth care solution ,other one for emollients To apply emollients To clean mouth and face after mouth care

ARTICLES FOR MOUTH CARE OF A PATIENT WHO IS ABLE TO CARE FOR HIMSELF: 

ARTICLES FOR MOUTH CARE OF A PATIENT WHO IS ABLE TO CARE FOR HIMSELF ARTICLES Small jug of warm water Brush Dentifrice Towel Feeding cup Kidney tray PURPOSE To gargle the patient mouth. To clean the teeth. Means toothpaste clean the teeth. To dry the face after mouth care. To pour water in mouth. To receive the used water

SOLUTION USED FOR MOUTHCARE: 

SOLUTION USED FOR MOUTHCARE Potassium permanganate: 1:5000(KMNO4) (1 crystal to glass of water) Sodium chloride- 1 teaspoon to a pint of water(normal saline) Potassium chloride – 4-6% Hydrogen peroxide (H2O2) 1:8

DENTRIFICES USED: 

DENTRIFICES USED Glycerin with lime juice equal part Sodium bicarbonate paste Reliable toothpaste or powder Neem stick NOTE: Hydrogen peroxide removes decaying food particles b/w teeth by its bubbling action and reduce bacterial activity from the cavities of tooth

EMOLIENTS USED: 

EMOLIENTS USED Cream or butter White Vaseline Liquid paraffin Glycerin borax Olive oil Readymade other can also use

PRELIMENARY ASSESMENT OF THE PATIENT AND ENVIRONMENT: 

PRELIMENARY ASSESMENT OF THE PATIENT AND ENVIRONMENT Identify the patient and observe the general condition of the client Check the condition of mouth Find out the ability of the patient to cooperate See the mood for the patient for acceptance and realization Assess the status of health habits of the patient to give health education.

PRELIMENARY ASSESMENT OF THE PATIENT AND ENVIRONMENT: 

PRELIMENARY ASSESMENT OF THE PATIENT AND ENVIRONMENT Decide the type of dentifrice and emollients to be used Assess the frequency of mouth care needed. Note the precaution to be observed while moving the patient Check the all articles available in the unit Make sure about any food or drink given after mouth care.

PREPARATION OF CLIENT LEGAL ASPECTS: 

PREPARATION OF CLIENT LEGAL ASPECTS Explain the procedure to the client. Explain about dentrifice,solution used for mouth care. Explain condition of client Clear the doubts of client. Take the consent.

PROCEDURE:FOR UNCONCIOUS CLIENT: 

PROCEDURE:FOR UNCONCIOUS CLIENT STEPS Wash hands Explain the procedure to the patient Place the patient in sitting or semi-sitting position. If possible, if not the head is turned to one side with the face along the edge of the pillow at bedside. PURPOSE To prevent cross-infection To get better cooperation from the patient To do procedure conveniently

PROCEDURE:FOR UNCONCIOUS CLIENT: 

PROCEDURE:FOR UNCONCIOUS CLIENT STEPS Put the curtains or screen Place mackintosh and towel across the chest and under chin Fill the solution in feeding cup. Keep the kidney tray close to cheek of patient with concave side towards him. PURPOSE To provide privacy to client To protect dress and bed linen To wash mouth To receive waste water

PROCEDURE:FOR UNCONCIOUS CLIENT: 

PROCEDURE:FOR UNCONCIOUS CLIENT STEPS Take gauze piece and wrap it fully around the forceps covering the tips. Completely moisten it after wrapping. Swab the teeth gently and firmly by the moistened swab on the forceps on both back and front of the teeth .each part swabbed with fresh swab discard used swab in paper bag. PURPOSE To clean the teeth properly. Cotton when wet is slippery. For proper cleaning all the area of mouth

PROCEDURE:FOR UNCONCIOUS CLIENT: 

PROCEDURE:FOR UNCONCIOUS CLIENT STEPS If brush used then moisten the brush with the solution and brush teeth thoroughly using the same movement. Pour solution on the brush holding over the kidney tray in between brushing.Rinse frequently. PURPOSE Immediately washing of brush ensures through cleaning and ready for next use

PROCEDURE:FOR UNCONCIOUS CLIENT: 

PROCEDURE:FOR UNCONCIOUS CLIENT STEPS Best way to ensure an equal amount of brushing on every tooth repeatedly. Number times p 3-5 times preferably in each area at a time in proper sequences. Rinse mouth with solutions. PURPOSE All surface of teeth and curve between teeth, gums To get anti septic effect.

PROCEDURE:FOR UNCONCIOUS CLIENT: 

PROCEDURE:FOR UNCONCIOUS CLIENT STEPS Allow the solution to run through the corner of mouth by turning the face to one side where the kidney tray is placed Remove kidney tray with waste water Apply emollients PURPOSE Not to spread waste water Not to spoil dress and bed For softening

PROCEDURE:FOR UNCONCIOUS CLIENT: 

PROCEDURE:FOR UNCONCIOUS CLIENT STEPS Clean the face with towel Give comfort position to the patient Remove all articles . PURPOSE For the comfort of the patient.

PROCEDURE FOR NORMAL CLIENTS: 

PROCEDURE FOR NORMAL CLIENTS STEPS Assemble the equipments to bed side. Place client in position Explain procedure to client Place the towel under chin Place kidney tray conveniently PURPOSE To use properly To provide comfort To understand condition To protect dress To receive waste water

PROCEDURE FOR NORMAL CLIENTS: 

PROCEDURE FOR NORMAL CLIENTS STEPS Help the patient to rinse mouth with water Apply dentifrice and hand over brush to the patient Instruct the patient to brush properly in circulatory method upward downward all sides PURPOSE To prevent dryness of mouth For cleaning of teeth To clean properly

PROCEDURE FOR NORMAL CLIENTS: 

PROCEDURE FOR NORMAL CLIENTS STEPS Help the patient to rinse mouth Ask the patient to rinse brush Help the client to wash face Provide the patient face towel PURPOSE To clean te paste from mouth To clean the brush so can use next time To give comfort to patient To dry the face

PROCEDURE FOR NORMAL CLIENTS: 

PROCEDURE FOR NORMAL CLIENTS STEPS Give comfort position to the patient Remove the articles Record the procedure in nurses chart PURPOSE Comfort of the patient

CARE OF DENTURES : 

CARE OF DENTURES The care of dentures ,it means care of artificial teeth. Client should be encouraged to clean their denture on a regular basis to avoid gingival infection and irritation. If client is disable then care giver should clean the denture. Denture should be handed with care they can easily broken .Denture must be removed at night to give rest to gums .discourage client to keep denture on a napkin or tissues because it can easily thrown away.

ARTICLES: 

ARTICLES Soft tooth brush Small basin Denture dentifrice or paste Water glass Gauze piece 4x4inch Denture cup Disposable gloves

PROCEDURE: 

PROCEDURE Explain and secure the cooperation of the client Arrange articles Place the tray on table if patient can give care himself Take to the utility room if you are giving Brush the denture with dentifrice Brush both surfaces of denture and well around the teeth

PROCEDURE: 

PROCEDURE Rinse denture and container in a running water under moderate flow of plenty of water with large kidney tray. Denture should cover with cold water when taken back to patient Give mouth care before replacing denture Tell patient to replace the denture if he is able (keep denture in cold water container, if not in use ,temporarily a few drops of peppermint essence in the water give them pleasant dour Replace all the articles and record the procedure.

PRECAUTION: 

PRECAUTION In cleaning denture they should handled well Denture should place in cool water Hot water will damage denture Privacy should be maintain

AFTER CARE OF THE CLIENT AND ARTICLES: 

AFTER CARE OF THE CLIENT AND ARTICLES Apply glycerin borax or any other emollient on the cracked lips and tongue to keep them soft Remove the kidney tray ,mackintosh and towel Make the client comfortable Tidy up the unit Incase of unconscious or seriously ill clients if there is collection of secretion in the mouth apply suction.

ORAL CARE IF NEGLECTED THAN COMPLICATION: 

ORAL CARE IF NEGLECTED THAN COMPLICATION LOCAL APPLICATION Parotitis-inflammation of parotid gland Stomatitis-inflammation of mucous membrane of the mouth Gingivitis-inflammation of gums Glossitis-inflammation of tongue

ORAL CARE IF NEGLECTED THAN COMPLICATION: 

ORAL CARE IF NEGLECTED THAN COMPLICATION Root abscess-pus formation in root of teeth Bleeding gums-deficiency of vitamin c and use hard brushing of the teeth COMPLICATION OF NEIGHBOURING STRUCTURES Parotitis-inflammation of parotid gland

ORAL CARE IF NEGLECTED THAN COMPLICATION: 

ORAL CARE IF NEGLECTED THAN COMPLICATION Rhinitis-Inflammation of sinus cavity Otitis media-Inflammation of tongue Tonsillitis-inflammation of tonsils Adenitis-inflammation of adenoids

ORAL CARE IF NEGLECTED THAN COMPLICATION: 

ORAL CARE IF NEGLECTED THAN COMPLICATION SYSTEMIC COMLICATION Anorexia-loss of appetite Bacterial endocarditis-inflammation of endocardium Gastritis-inflammation of stomach

ORAL CARE IF NEGLECTED THAN COMPLICATION: 

ORAL CARE IF NEGLECTED THAN COMPLICATION Nephritis-inflammation of kidneys Rheumatic arthritis-inflammation of joints

PREVENT OF COMPLICATION : 

PREVENT OF COMPLICATION The teeth of every patient needs through cleansing a brushing at least twice a day Washing mouth before and after meals If teeth gum in bad condition, clean 4 th hourly Client should take consultation.

RECORDS AND REPORTS: 

RECORDS AND REPORTS Document assessment of teeth ,tongue, gums and oral mucosa. Including any problems such as sores or inflammation and swelling of gums. Record the procedure the procedure solution used, emollient used all details should be recorded in nurses record.

HEALTH EDUCATION: 

HEALTH EDUCATION Health education is one of the importance aspect in caring of clients. It will help to maintain health of client as a care giver. We should identify the habit of clients. If patient have any habit like tobacco, smoking we should advice to client to stop that habit and should explain the complication of mouth which can occur if mouth care neglect. Make understand the concept to client and clear doubts.

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APPEALED BY :- MK MR.GIBIN SUNNY ASST.LECTURER NUINS.CON NUINS