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oral care.pptx

The document discusses the importance of oral hygiene and provides detailed guidelines for mouth care, especially for patients who are unconscious or have specific health conditions. It outlines various solutions used for cleansing, the procedure for mouth care, and the scientific principles underlying oral hygiene, including anatomy, microbiology, and the effects of diet on dental health. Additionally, it emphasizes the necessity of maintaining oral cleanliness to prevent infections and dental diseases.

Education◦
Care of the mouth Normally the mouth is kept clean in health. Because the mouth is the portal of entry for food and digestion is started here. So the condition of the mouth directly affects health. Oral hygiene is the practice of keeping your mouth clean and disease-free.
Purposes  To feel fresh and clean and socially accepted.  To prevent and treat mouth infections.  To stimulate salivation.  To prevent infection of parotid glands  To help to increase appetite.  To prevent dental carries and tooth decay.
The patients who may require mouth care  Unconscious patients and helpless patients.  Patients with high fever.  Patients on fluid diet or milk diet.  Paralysed patients.
The patients who may require mouth care  Seriously ill patients.  Patients having a local disease of the mouth.  Patients who are on artificial feeding and who are not taking oral feed.  Malnourished and dehydrated patients.
Solutions used  Potassium permanganate - [KMNO4] - 1: 5000. a pink colour. It should be made fresh each time. Used as a oxidizing agent to clean the mouth.  Hydrogen peroxoide - [H2O2] 5 cc to 20 cc as a deodorizing agent.
Solutions used  Normal saline - 1 teaspoon to a pint of water. It is used for cleansing purpose.  Soda-bi-carb - 1 Tsf to a pint of water. It dissolves the coating of mucus membrane and cleanse the mouth.  Glycerine Borax - It is hygroscopic and used to soothe or soften the mucus membrane. Useful when the lips are dry and cracked.
 Parotitis - Inflammation of the parotid glands.  Stomatitis - Inflammation of the mucus membrane of the mouth.  Gingivitis - Inflammation of the gums.  Glossits - Inflammation of the tongue.  Otitis media - Inflammation of the middle ear.
 Pyorrhoea - Pus formation in the sockets of teeth.  Tonsilitis - Inflammation of the tonsils.  Gastritis - Inflammation of the stomach.  Anorexia - Loss of appetite.
Articles  A Clean tray containing - 1. Artery forceps - 1. 2. Dissecting forceps - 1. 3. Face towel - 1. 4. Treatment mackintosh. 5. Cotton swabs in a bowl. 6. Tongue depressor. Tongue depressor.
Articles  A clean tray containing - 7. A bowl with clean water. 8. Kidney tray and paper bag. 9. Gauze pieces. 10. Feeding cup. Solution ordered. 11. Glycerine borax. 12. Swab sticks to apply the glycerine borax. 13. Mouth gag. (If patient is unconscious to open the mouth.) Mouth gag.
1. Explain the procedure to the patient [ if the patient is conscious] to gain the confidence and co-operation of the patient. 2. Give comfortable position to the patient. Procedure
3. Screen the patient. Arrange the articles conveniently. 4. Wash hands to prevent cross infection. 5. Place the mackintosh and towel beneath the patients chin. Place the kidney tray close to the cheek. 6. Prepare the antiseptic lotion for the mouth wash, prepare a paste with soda bicarbonate or salt.
7. Do not pour water into the mouth, if the patient is unconscious, because due to poor gag reflex the fluid will go into the trachea wrap a swab around the forceps covering the tips completely and clean the mouth systematically changing the swabs as often as necessary. If the patient is wearing dentures, remove these first and place them in a bowl of water, clean the mouth in the following order - Inside the cheeks. - Gums. - Teeth. - Roof of the mouth. - Lips.
8. Wipe the tongue gently from side to side. If necessary use tongue depressor to control the movements of the tongue, by depressing it. 9. For a conscious patient - tooth brush and paste can be used. 10. As each swab becomes soiled, remove it with the dissecting forceps, and wrap clean swab round the artery forceps.
11. Repeat the whole process with swabs dipped in the solution and then fresh water. 12. When the teeth and tongue cleaned well, stop the procedure, wipe the lips and face with the towel. 13. Apply glycerine borax on the cracked lips and tongue, because glycerine attracts water and heep them soft.
After care of patient & articles  1. Remove the kidney tray, treatment mackintosh and towel. 2. Make the patient comfortable. 3. Replace cleaned dentures if worn. 4. Take all articles to the utility room, discard the wastes and clean them with soap and water. 5. Boil the forceps and replace them in their usual places. 6. Wash hands.
Recording Reporting  1. Record the procedure with date and time, and the condition of the mouth on the nurses record. 2. Report any abnormal condition to the ward sister and physician. 3. Give health education to the patient and his relatives on oral hygiene.
Scientific principles of mouth wash  Anatomy and Physiology - 1. Oral or buccal cavity is formed as follows - The lips are in front, the cheeks on the sides, and the back communicates with the pharynx. 2. The mouth is lined with mucus membrane. 3. There are six openings opened in the pharynx. Two openings of the nostrils, one trachea, one oesophagus and two are of eustachian tubes. 4. The mouth contains the tongue, salivary glands, and teeth.
Scientific principles of mouth wash  Tongue- The tongue is made up of skeletal muscles and is covered with mucous membrane. The papillae on the tongue contains taste buds. Sweet taste in the front, bitter at the back and sour and salty taste is at the side of the tongue. The function of the tongue is it helps speaking and in eating. 5. Salivary Glands - There are three sets of salivary glands, in the mouth. Namely parotid, sublingual and submaxillary glands. They secrete saliva when the taste buds are stimulated by the smell, sight, feel and thought of food. Saliva contains ptyalin, which hydrolyzes strach. 6. Teeth - Temporary or Deciduous teeth are 20 in number and permanent teeth are 32 in number.
Scientific principles of mouth wash 7. The teeth are covered by a dense fibrous membrane over which is smooth mucous membrane called gums. 8. Each tooth has three parts - a root, a neck, and a crown. The outside of the crown is enamel which is the hardest substance in the body and it is affected only by acids. 9. The outside of the root is cement. Under the enamel of the crown and the cement of the root is dentine. Dentine contains tubules which brings nourishment. 10. The pulp of the tooth, lies within the dentin. Pulp contains blood vessels and nerve branches from the fifth cranial nerve. 11. For normal development of the teeth mastication of hard fibrous food, firm, raw fruits and vegetables are required.
Scientific principles of mouth wash  Microbiology - 1. Many bacteria are found in normal healthy mouth, among which are the pneumococci, the staphylococci and the streptococus. 2. Saliva is mildly bactericidal. 3. The mouth represents all requirements for bacterial growth - warmth, moisture, food supply from the residual foods on and between the teeth and a protected environment. 4. If oral hygiene is not maintained it will lead to the diseases of the teeth and mouth. 5. Mouth washes help to remove food particles after they have brushed from the teeth.
Scientific principles of mouth wash 6. Oral cleanliness is preventive against dental carries. 7. Bacillus acidophilus causes dental carries. It acts on carbohydrate material which is left on the surfaces and produces lactic acid that dissolves the tooth structure. 8. The molars, the bicuspids and upper incisors are most liable to decay. 9. Inflammation of the gums may be caused by poor oral hygiene, bacterial infection or deficiency of vit. C in the diet. Gingivitis may lead to pyorrhoea. 10. Sores is a collection of food, mucus and bacteria in the mouth and on the lips. It may lead to infection in the mouth or adjacent tissues. 11. Dentures should be cleaned well, especially in and around the claps.
Scientific principles of mouth wash  Physics and Chemistry - 1. Soap is a constituent of most dentifrices, has a low surface tension so that it spreads readily over the teeth and penetrates between them. 2. Friction of raw foods against the teeth and gums produces stimulation. 3. The force of chewing, pushing the gelatinous bacterial plaque and lactic acid into the pits and crevices, may be partially responsible for the speed of dental decay. 4. A dentures should be dipped in cold water to avoid friction with the mouth and to make it slide easily into place. 5. When a nurse attending mouth care the pt should be near the working side of the bed to prevent strain for the patient and the nurse. 6. The nurse should stand erect to avoid strain on back muscles.
Scientific principles of mouth wash  7. The teeth are formed of calcium and phosphorus. So for healthy growth of the teeth these minerals are necessary. 8. Vitamin D helps in the assimilation of the calcium and phosphorus. 9. Vitamin A controls the growth of enamel. 10 Vitamin C is necessary for formation of dentin. 11. Saliva consists of 99.5 percent water and 0.5 percent total solids. Its constitutnts are water, inorganic salts, mucin, traces of protein and salivary amylase or ptyalin.
Scientific principles of mouth wash 12. Saliva is slightly acid in reaction and its pH is between 6.35 to 6.85. Sweets increase the acid reaction of the saliva. 13. Tartar consists of mineral matter precipitated from saliva mixed with food debris. The pressure of tartar against the gums irritates them and lowers their resistances to bacteria. 14. The flourine limits the bacterial activity and reduces the acid reaction of the saliva. 15. Synthetic vit. K retards the formation of acid in the mouth. 16. Dentifrices clean the mouth by mechanical action rather than chemical action on bacteria.
Scientific principles of mouth wash  Pharmacology - 1. Glycerine with lemon juice helps in softening dry lips. 2. All liquid dentifrices contain antiseptics such as boric acid, phenol, thymol etc. and flavoured with pappermint, cinnamon floves etc. 3. Salt solution is a good mouth wash.
Scientific principles of mouth wash  Psychology - 1. A clean mouth makes a person feel fresh, clean and comfortable. 2. Daily brushing of teeth is a desirable esthetic habit. 3. A set of sound teeth is valuable asset as it contributes to personal apperance. 4. Privacy should be provided to the patient while caring for his dentures.
oral care.pptx