CNA Skill: Providing Oral Care for A Patient

Oral care procedures are used for patients who are unconcious or who are not able to eat or drink.  Keeping the mouth and teeth clean will protect your patient’s oral health and allow quicker recovery by preventing infections from developing.  Before you begin, wash your hands and put on a pair of gloves.  Greet your patient, and explain what you are going to do in order to allow the patient to assist if they are able.  For an unconcious patient, provide care as follows:

1. Drape a towel over the patient’s chest.  Raise the bed to allow you to comfortably work.  Raise the head to an angle no greater than 30 degrees.
2. Gently turn the patient’s head toward you, and open the mouth using a tongue depressor in one hand.
3. Using a toothbrush, clean the patient’s mouth including teeth, gums, and tongue.  Be careful to use only a small amount of toothpaste to preven excess from being swallowed.
4. When you have completed brushing, suction saliva and toothpasted from the patient’s mouth.  Assist your patient back into a comfortable position.  Dispose of gloves and wash your hands.

For a patient who is concious, the procedure is as follows:

1. Wash hands, put on a pair of gloves, and place a towel over the patient’s chest.  Raise the head to an angle no greater than 30 degrees.
2. Using a toothbrush, clean the patient’s mouth including teeth, gums, and tongue.  Be careful to use only a small amount of toothpaste to preven excess from being swallowed.
3. As you brush the patient’s teeth, inspect themouth for signs of infection such as lesions or abscesses.
4. If the patient is able, allow him or her to take a small amount of water into the mouth and swish to remove remaining toothpaste.  Otherwise, you will need to suction saliva and toothpaste from the mouth.
5. Assist your patient back into a comfortable position.  Dispose of gloves and wash your hands.

Helping your patient with this self care task contributes to overall health as well as comfort.  Oral infections can become both painful and dangerous if not treated, and you may be able to detect these infections by careful observation during the oral care process.

Examiners Checklist For This Skill:

1) Performed beginning tasks.
2) Positioned resident.
3) Cleaned oral cavity using appropriate oral hygiene products.
4) Rinsed oral cavity.
5) Repeated steps 3 and 4 until oral cavity was clean.
6) Cleaned and rinsed teeth, dentures if applicable.
7) Assisted resident to clean and dry mouth area.
8 ) Performed completion tasks.

Expert Tip by Tanya Glover, CNA

Ah oral care. This is one of the four skills I was slammed with during my exam. It may sound like a piece of cake, but it can be quite nerve wracking. When I first began my job as a CNA it was hard for me to do all of the tasks. It was not that I was unskilled, rather I felt uncomfortable doing these personal things for people who were my elders. I was upset that it would embarrass them to have a stranger care for them in such an intimate way when they were once vital and independent people. Needless to say I got over it and you will too.

Now, back to the skill. When I was told that oral care was one of my skills, I froze with fear. My skills test partner was a handsome young man with beautiful teeth and now I had to pretend he was a patient who needed them brushed. If you have never brushed another adults teeth you will not get this until you have to. So many things run thorough your head (even if your partner is not cute!) You worry that you will be too rough. You worry that you will look foolish. Both of these things can actually happen but who cares? Do it right and you pass! Let your worries overcome you and you will fail. It is just that simple. Here is the trick I used to get through it; I pictured my partner as one of my kids and just did my thing. Since I did it all right AND remember the hand washing (before and after), I passed the skill and here I am today! Licensed after almost 13 years! Ole’!