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Maintaining oral hygiene in elderly dentate adults in nursing

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Introduction

´╗┐Maintaining oral hygiene in elderly dentate adults The Department of Health (2010) regards oral hygiene as a priority in maintaining high standards of patient care. Oral hygiene is vital for general health and wellbeing, notably to perform functions such as eating, speaking and non verbal communication (The Health and Social Care Information Centre 2011). Findings by the Adult Dental Health (2009) survey revealed that standards of oral health deteriorate with age. This is significant as the number of patients aged 75 and over admitted to hospital has risen by two thirds within the past ten years and this trend continues to grow (The Health and Social Care Information Centre 2011). This suggests that many elderly dentate patients may be admitted to hospital with pre existing dental problems or poor standards of oral hygiene. Poor oral hygiene can prove detrimental to health leading to serious oral conditions including tooth decay, periodontal (gum) disease and xerostomia (dry mouth) (DH 2007). Swelling and pain associated with oral conditions can directly impact upon ones quality of life (DH 2007). For instance behaviours and choices adopted in response to oral discomfort can potentially lead to poor nutritional intake and place one at risk of malnutrition (Malkin 2009), notably having an impact on a key benchmark of patient care ?Food and drink? (DH 2010). The effects of poor oral hygiene such as missing teeth or an unpleasant smell can also leave one feeling self conscious (DH 2007) ...read more.

Middle

and dignity is maintained (NMC 2010). The environment must be considered to maintain privacy and dignity (DH 2010, NMC 2010). It is best practice to assist a patient to the bathroom to use a sink (Mooney 2007), however this opportunity is often missed for patients who experience mobility problems (Endacott et al 2009). From practice it was observed that this could be overcome through using mobility aids in the hospital setting such as a zimmerframe or commode (with the lid on) to transport a patient to the bathroom. This facilitates a patient?s right to self care (DH 2010) and respects their autonomy (Xavier 2000). If this is not feasible, as in the case of bed bound patients Mooney (2008) recommends that a container should be placed under the patients chin and curtains must be drawn. Knowledge and skills are crucial when delivering oral hygiene (DH 2010) demonstrated through the technique employed (NMC 2008). Endacott et al (2009) details a systematic approach to cleaning a patient?s teeth, involving brushing the top and bottom teeth, from the back to front in a circular motion holding the brush at 45 degrees to the teeth?s surface. This is continued by cleaning of the biting surfaces at 90 degrees and brushing of the gums, tongue and roof of the mouth (Endacott et al 2009) to ensure plaque is removed (BDHF 2010). A holistic approach must be adopted to inform patient care (NMC 2010). ...read more.

Conclusion

Clinical Nursing Skills: Core and Advanced. 1st ed. OUP Oxford. Malkin B. (2009) The importance of patients? oral health and nurses? role in assessing and maintaining it. Practice review. 105(17) 19-23. Pearson L.S. & Hutton J.L. (2002) A controlled trial to compare the ability of foam swabs and toothbrushes to remove dental plaque. Journal of Advanced Nursing, 39(5), 480-489. Wilson A. (2011) How to provide effective oral care. Nursing Times, 107(6), 14-15. Wood A. (2008) Mouth care and ritualistic practice. Cancer nursing practice. 3(4) 34-39. Xavier C. (2000) The importance of mouth care in preventing infection. Nursing Standard. 14(18), 47-51. Department of Health (2010) Essence of Care 2010. Retrieved from http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_119969 on 1st December 2011 Department of Health (2007) Impacts of poor oral health. Retrieved from http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/Browsable/DH_5521284 on 05th December 2011 Mooney G. (2007) Mouth care. Nursing Times. Retrieved from http://www.nursingtimes.net/nursing-practice/clinical-specialisms/practice-nursing/mouth-care/199385.article on 10th December 2011 National Institute for Health and Clinical Excellence (2008) Technical patient safety solutions for ventilator-assisted pneumonia in adults (PSG002). Retrieved from http://www.nice.org.uk/guidance/index.jsp?action=byId&o=12053 on 05th December 2011 National Institute for Health and Clinical Excellence (2003) Infection Control; Prevention of health-care associated infection in primary and community care. Retrieved from http://www.nice.org.uk/nicemedia/live/10922/29117/29117.pdf on 05th December 2011 Nursing and Midwifery Council (2008) The code: Standards of conduct, performance and ethics for nurses and midwives. Retrieved from http://www.nmc-uk.org/Documents/Standards/The-code-A4-20100406.pdf on 02 December 2011 The British Dental Health Foundation (2011) Caring for my teeth. Retrieved from http://www.dentalhealth.org/tell-me-about/topic/caring-for-teeth/caring-for-my-teeth on 30th December 2011 The NHS Information Centre for health and social care (2011) Adult Dental Health Survey 2009 - Summary report and thematic series. Retrieved from http://www.ic.nhs.uk/statistics-and-data-collections/primary-care/dentistry/adult-dental-health-survey-2009--summary-report-and-thematic-series on 30th December 2011 ...read more.

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