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Royal North Shore Hospital Nursing and Midwifery
Nursing Research and Practice Development
The Principles of Effective Oral and Denture Care in Adults
Oral health is essential to good health and quality of life, and is defined by the World Health Organisation (2018) as “a state of being free from mouth and facial pain, oral and throat cancer, oral infection and sores, periodontal (gum) disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psychological wellbeing.” That is certainly a mouthful…so to speak. In addition to the WHO’s definition it is also essential for the prevention of Non-ventilator Hospital Acquired Pneumonia, or NV- HAP. Despite being so important it is one of the most fundamental aspects of nursing care and often one of the most frequently overlooked . Evidence suggests that oral health deteriorates while people are in hospital. Many of your patients will be able to perform their own mouth care, however, may need to be reminded whilst in hospital and out of their usual routine. The most effective form of mouth care is to use a soft bristled tooth brush and toothpaste whenever this is possible twice per day. Only in the presence of immunocompromise, significant gum disease or mucosal compromise should alternatives be considered.
Oral assessment is as essential as skin assessment and should occur on admission and routinely at intervals depending upon your patient’s risk profile and then a plan of care developed in consultation with the patient.
Barriers to providing effective oral care are:
Lack of adequate training.
Lack of mouth care assessment tools, policies and equipment.
Mouth care will therefore be one of our focus areas for practice development in 2022 .
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