ORAL CARE

I. Assisting a Non-dependent Client for Oral Care

1. Explain the procedure.
2. Gather the equipment.
3. Close the door or curtain or put screen
4. Perform hand hygiene and wear disposable gloves (mandatory)
5. If using a solution such as Sodium Bicarbonate, prepare the solution required.
6. Assist the client to a comfortable upright or sitting position.
7. Inspect the oral cavity.
a. Inspect the whole oral cavity using a gauze-padded tongue depressor and torch
b. Take note for any abnormalities (e.g. bleeding, swollen ulcers, sores, etc.)
8. Place the face towel over the client’s chest or on the thigh with mackintosh
9. Put the kidney tray on the client’s hand or assist the client by holding the kidney tray
10. Instruct the client to brush the teeth.
a. Client places the soft toothbrush at a 45 degree-angle to the teeth.
b. With toothpaste, client brushes in direction of the tips of the bristles under the gum line.
Rotate the bristles using vibrating or jiggling motion until all outer and inner surfaces of the
teeth and gums are clean.
c. Brush the biting surfaces of the teeth.
d. Clean the tongue from the inner to outer direction.
11. If the client cannot tolerate toothbrush (or toothbrush is unavailable), form and use cotton swabs
or cotton balls. When client is prone to bleeding or pain, toothbrush is not advisable.
12. Rinse the oral cavity.
a. Ask the client to rinse with fresh water and void contents into the kidney tray.
b. Advise him/her not to swallow the water.

II. Assisting a Dependent Client for Oral Care

- Lateral position with head tuned toward the side. (R: To provide drainage and prevent accidental
aspiration.)
1. x x x
2. Keep the client in a side lying or in a comfortable position.
3. Place the mackintosh and towel on the neck to the chest.
4. Put the kidney tray over the towel and mackintosh under the chin.
5. Inspect the oral cavity.
6. Clean the oral surfaces.
a. Ask the client to open the mouth and insert the padded tongue depressor gently from the
angle of the mouth toward the back molar area. Never use your fingers to open the client’s
mouth.
b. Clean the client’s teeth from incisors to molars using up and down movements from gums to
crown.
 c. Clean the oral cavity from proximal to distal, outer to inner parts, using cotton ball for each
stroke.
7. Discard the used cotton ball into the small kidney tray.
8. Clean the tongue from inner to outer aspect.
9. Rinse the oral cavity.
a. Provide tap water to gargle and position the kidney tray.
b. If the client cannot gargle by his or her own,
b.1. Rinse the areas using moistened cotton balls; or
b.2. Insert the rubber tip of an irrigating syringe into the client’s mouth and rinse gently with
a small amount of water.
c. Assist to void the contents into the kidney tray. If the client cannot spit up, especially in the case
of unconscious client, suction any solution.
d. Confirm the condition of the client’s teeth, gums, mucosa, and tongue.
e. Wipe the water around the mouth. Apply lubricant to lips by using foam swab or gauze piece
with artery forceps.

HAIR WASHING

1. Perform hand hygiene. Wear gloves.

2. Gather all equipment.
3. Check the condition of the client. Explain the purpose and the procedure.
4. Bring and set up all the equipment to the bedside.
5. Help the client move his or her head towards the edge of the bed and remove the pillow from the
head.
6. Put another pillow or a cushion under the bending knee. Make the client comfortable.
7. Set the mackintosh and the towel.
a. Place the mackintosh covered with a big towel under the client’s head to the shoulders;
b. Place a big towel around the client’s neck;
c. Roll another mackintosh to make the shape of a funnel by holding both sides in a slanting
way. The narrow end should be folded an put under the client’s neck