Mouth care for a patient with dentures

Authors: V.Rednenko 

Editor: V.Rednenko 

Equipment for the practical skill:

• Simulated patient (patient manikin)
• Hospital bed with bedding
• Over-bed table
• Towels (Paper towels)
• Gloves
• Protective eyewear and a gown (optional; use if blood may splash or spray)
• Toothbrush
• Toothpaste
• Denture cup
• Disposable mouth sponges
• Emesis basin
• Cup
• Floss pick or dental floss
• Mouthwash
• Lip balm or petroleum jelly and cotton-tipped applicator

Clinical situation:

Patient N. is in the neurological department with acute cerebrovascular accident, he is assigned to Brushing and Flossing a Person’s Teeth. The patient has dentures.  Carry out the prescribed procedure.

Order of the skill performance:

Preparatory stage:

• Introduce yourself
• Identify patient
• Obtain informed consent to the procedure (if the patient's condition allows it)
  • Give all the information to the person about what the procedure involves, including the benefits and risks, whether there are reasonable alternative, and what will happen without this procedure
  • Explain what you are going to do.
  • Ask the patient to consent to procedure.
  • Explain to the patient how he can help.
• Make sure you have the necessary equipment and put it on the over-bed table (the chair next to the bed)
• Sanitize your hands, put on gloves
• Prepare the patient bed:
• Raise the bed to a comfortable working height.
• Make sure the wheels on the bed are locked

Main stage:

• Cover the over-bed table with the paper towels and arrange your supplies. In the cup, prepare a solution of half water and half mouthwash.
• Position the person in high Fowler's position.
• Remove the Denture
  • Unfold the towel. Place it across the person’s chest.
  • Put on the gloves and any other personal protective equipment. Have the person remove her denture and put it in the emesis basin. If the person needs assistance removing the denture, grasp the denture firmly with your thumb and index finger and use a rocking motion to gently remove the denture and put it in the emesis basin. A person may wear more than one denture (for example, one to replace the upper teeth and one to replace the lower teeth). If necessary, repeat to remove the other denture.
• Clean the Denture
  • Take the emesis basin, the denture cup, the washcloth, the denture brush or toothbrush, the denture toothpaste and the denture-cleansing tablet (if used) to the sink.
  • Line the sink with the washcloth or several paper towels.
  • Using a paper towel, turn on the faucet and adjust the water temperature so that it is cool.
  • Wet the toothbrush and apply denture toothpaste.
  • Allow the sink to fill halfway with cool water.
  • If the person has more than one denture, clean one denture at a time. Remove one denture from the emesis basin and hold it in the palm of your hand over the sink. Use the toothbrush to clean all surfaces of the denture, using circular movements.

• • Rinse the denture thoroughly under cool, running water and place it in the denture cup.
  • If the person will not be putting the denture back in the mouth right away, add enough cool water to the denture cup to cover the denture. Add a denture-cleansing tablet, if used, and replace the lid.
  • Turn off the faucet with a paper towel.

• Provide Care for the Person’s Mouth
  • Take the denture cup and the emesis basin back to the person’s bedside.
  • Give the person a mouthful of the mouthwash mixture to rinse her mouth. Hold the emesis basin under the person’s chin to catch the liquid. Dry the person’s mouth and chin with the towel.
  • Help the person clean the roof of the mouth, the inside of the cheeks, the gums, under the tongue, and the lips with mouth sponges dipped in the mouthwash mixture.

• • If the person has any natural teeth, help her brush and floss them.
  • Give the person a mouthful of the mouthwash mixture to rinse her mouth. Hold the emesis basin under the person’s chin to catch the liquid.

• • Dry the person’s mouth and chin with the towel.
  • Have the person put the denture back in the mouth. If the person needs assistance, grasp the denture with your gloved thumb and index fi nger and guide it into place. If the person is not returning the denture to the mouth right away, make sure the denture cup is within the person’s easy reach.
  • Dry the person’s mouth and chin with the towel, and place the towel in the linen hamper.
  • Encourage the person to apply lip balm or petroleum jelly to the lips. Assist the person as needed.

• Remove and dispose of your gloves.

Final stage:

• Ensure the person’s comfort and good body alignment.
• Adjust equipment for safety: Lower the bed to the level specifi ed in the person’s care plan. Make sure the wheels on the bed are locked. Place the person’s method of calling for help within reach. Lower or raise the side rails according to the person’s care plan.
• Clean up your work area.
• Wash your hands.