Maintaining oral hygiene in elderly dentate adults in nursing

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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) and affect their ability to exchange information through verbal and non verbal  ‘communication’, another key benchmark for patient care (DH 2010).   Nurses are in a key position to facilitate and promote high standards of oral hygiene (Wood 2008, Xavier 2000), through providing assistance, equipment, a suitable environment and possessing specialist knowledge and skills to provide mouth care (DH 2010).  

Elderly patients may require more assistance with mouth care due to the prevalence of physical and mental conditions that can affect this age group, notably vision and motor control impairments and states of confusion such as dementia (Fitzpatrick 2000). Nurses should provide mouth care for those patients who are unable to maintain their own oral hygiene needs (Wilson 2011).  The level of assistance required or even desired by the patient can be deciphered by consulting patient care plans and communicating directly with the patient (Endacott et al 2009) An understanding of the patient’s background, current condition and how they are feeling today can inform the way in which mouth care is provided (Endacott et al 2009) and promote a patient centred approach (DH 2010).

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Equipment must be supplied to facilitate mouth care (DH 2010).  Numerous products are available, including toothbrushes, foam swabs and mouthwashes for brushing and rinsing (Endacott et al 2009). The quality of each of these products in providing mouth care has been researched extensively. For instance a study by Pearson and Hutton (2002) concluded that toothbrushes are more effective at removing dental plaque than foam swabs.  Plaque is known to cause tooth decay and periodontal (gum) disease, both factors that contribute to poor oral hygiene (The Health and Social Care Information Centre 2011).  Although these findings are conclusive in identifying ...

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