Personal Hygiene : Oral Hygiene

ORAL HYGIENE

The Oral cavity is lined with mucous membrane continuous with the skin. The mucuous membrane is an epithelial tissue that lines and protects organs, secretes mucous to keep passageways of digestive system moist and lubricated, and absorbs nutrition.

Purposes of Oral Hygiene:

            Oral Hygiene helps maintain the healthy state of the mouth , teeth, gums and lips.

            Brushing cleanses the teeth of food articles, plaque and bacteria.

             Brushing massages the gums.

            Brushing relieves discomfort resulting from unpleasant odours and tastes.

            Flossing helps remove plaque and tartar from between teeth to reduce the gum inflammation and infection.

             Oral hygiene gives a sense of well being.

             Proper Oral hygiene stimulated appetite.

             To improve taste

Proper Oral Hygiene

            Good oral hygiene involves cleanliness, comfort and the moisturizing the mouth structures. Proper care prevents oral disease and tooth destruction.

            Brushing, flossing and irrigation are necessary for proprer cleansing.

To prevent tooth decay, reduces the intake of carbohydrates, especially sweet snacks between meals.

            Brushing of the teeth atleast four times a day is a basic to an effective oral hygiene(after meals and at bed time)

            Tooth brushes should be replaced every three months

            After brushing,thorough rinsing is important to remove dislodged food particles

Risk factors for Oral problems

            Patients  who are paralyzed or seriously ill.

            Unconscious patients

            Diabetic patients

            Patients undergoing radiation theraphy

            Patients receiving chemotheraphy

            Patients having oral surgery, trauma

            Patients with immunosuppression drug eg HIV patients

Common Oral problems

The two major types of oral problems are dental caries (cavities) and periodontal disease ( Pyorrhea)

            Dental caries is the most common oral problem of younger people. The development of the cavities involve the destruction of tooth enamel through decalcification. Decalcification is a result of an accumulation of mucin, carbohydrates and lactic acid bacilli in the saliva normally found in the mouth, which forms a coating on the teeth called plaque.

Plaque is transparent and adheres to the teeth near the base of the crown at the gum margins. The plaque prevents normal acid dilution and neutralization, preventing the dissolution of bacteria in the oral cavity. The acid eventually destroys the tooth enamel and in severe cases, the pulp, or inner sponge tissue of the teeth.

Periodontal disease is the disease of the tissue around the tooth. It is an inflammation of the periodontal membrane. It is the most common problem of people over 35 years of age.

The calculus deposit on teeth at the gum line. The gingivae become swollen and tender. Then the inflammation spreads, pockets develop between gums and gingivae. The alveolar bone is destroyed and the teeth loosen.

3) Halitosis (Bad breath) is a common problem of the oral cavity.

Causes :  (i)      poor oral hygiene

                inspection of the oral cavity

                liver disease

                diabetes

            Cheilosis is the disorder involves cracking of the lips

especially at the ankle of the mouth. Causes (i) Riboflavin deficiency

(ii) Mouth breathing

             Excess salivation

            Stomatitis is an inflammative condition of the mouth.

causes (i)   contact with irritants such as tobacco

            Vitamin deficiency

              infection by bacteria, viruses or fungi

              Use of Chemotherapeutic drugs

            Glossitis is an inflammation of the tongue resulting from an infectious disease or injury such as burn or bite.

            Gingivitis is a inflammation of the gums usually resulting from poor oral hygiene.

            Oral malignancies: lumps are ulcer appears in or around the mouth. The most common site is at the base of the tongue.

causes  (i)   pipe smoking

                 tobacco chewing

Equipments:

A tray containing

            Cotton swab or clean linen pieces in a bowl

            Forceps ( artery and dissecting forceps)

            Gallicups 2 nos. ( one for Glycering borax another for salt solution)

            Feeding cup with salt solution

            Kidney trays 2

            Swabs sticks

            Rubber sheet

            Towel

            Wash towel

Procedure:

            Place all the articles at conveniently on the bedside table.

            Explain the procedure to the patient

            Put the rubber sheet (mackintosh) with towel and kidney tray under the chin

            Have the patient rinsed his mouth with salt solution form the feeding cup

            Turn the patient' s head to one side

            Take the artery forceps, wrap a piece of linen around the tip of the forceps

            Dip it inside the saline water and clean the teeth with up and down movements.

            Pay special attention to inside the mouth, gums, inside the cheeks, tongue and the roof of the mouth

            Change linen pieces as often as necessary.

            Discard used cotton in the other kidney tray

            Allow the patient to gargle as much as necessary

Dip the swap stick in glycerin borax, swab gums, root and sides of the mouth.

After care of Equipments:

            Clean kidney trays and feeding cups with soap and water.

             Boil forceps, and gallicups after cleaning

            Place all articles in their places after cleaning and boiling.

Care of Dentures

If the patient has dentures, care should taken to keep the dentures clean. If the patient is unable to do so, the nurse has to remove the dentures by grasping it with gauze pieces, place them in a tumbler or cup containing water. Dentures are washed carefully busing brush, toothpaste and cool water. Water, which is too hot, may injure the composition of dentures. If the patient is to do by himself, he may be assisted. Remove dentures of patients who are unconscious, mentally ill and who have vomiting or cough spasm