Mouthing off about oral care

Care homes are being urged to keep on top of oral hygiene to help prevent a
slew of medical conditions.

Speaking at a recent NACC North seminar, Amanda Mclaughlin, healthcare manager, RIS Healthcare, advised oral care assessments should be completed within 48 hours of a resident being admitted.

“Body mapping is standard practice but most homes don’t do
a full oral check,” she said. “The mouth should be clean, healthy
and moist, and any relevant information should be added to that person’s care plan. We need to be treating the mouth with the respect it deserves.

“We don’t want to have residents with mouths that smell and their family don’t want to kiss them goodbye. People are in care homes because they require our help.”

A lot of drugs can cause oral health to deteriorate, explained Amanda, so it’s important to forge a two-way relationship between general health and oral health.

“Without good periodontal health you can’t have good general health,” she continued. “Peridontal (gum) disease can cause respiratory infections, strokes, heart disease, uncontrolled diabetes and severe osteopenia (reduced bone mass).”

Poor oral health can also cause behaviour problems; inability to eat and speak; diet, nutritional and hydration problems; weight changes; problems with social interactions, and poor quality of life.

How to Clean Dentures – Toothpaste is not recommended and manual cleaning is a must. Use liquid soap or denture cream cleaner, and a nail
brush/denture brush. Denture soaking solutions should be used as per instructions and, if fungal infection is present consider soaking in a dilute Milton solution each evening for 10 minutes.
Leave the dentures in plain water overnight.

Denture Marking– Around 9,500 dentures are lost every year in hospital – costing the NHS £1 million – so care homes are advised to do denture marking:
• Remove dentures from person’s mouth
• Clean dentures in soapy water with nail/denture brush
• Disinfect denture by soaking in dilute Milton solution for 30 seconds (if a metal denture use a Dentural cleansing solution)
• Dry denture
• Use an indelible pen to write residents’ initials near back of denture. Wait to dry
• Apply fine layer clear nail varnish
• Rinse with water

Mouth care for residents with challenging behaviour– Carers are advised to take a calm and kind approach, and maintain eye contact. Choose a location where the resident feels most comfortable (bedroom or bathroom) and, if necessary, ask a family member or carer for assistance. Try different times of day and do it in short bursts. Always use a familiar toothbrush and toothpaste. For residents with oral sensitivity, consider flavourless/ non-foaming toothpaste.

Things to look out for:

• Dry, rough tongue
• Sore painful mouth and tongue
• Oral fungal infections
• Lips sticking to the teeth and taste disturbance
• Bad breath
• Sticky, dry feeling in the mouth
• Trouble chewing, swallowing, tasting, or speaking
• Burning feeling in the mouth
• Dry feeling in the throat
• Cracked lips and or corners of the mouth