Oral Care

Table of Contents

Oral care may be required for children who pocket food in their mouth. Learners who have trouble chewing may be required to eat softer or pureed foods, which have a high tendency to stick to their teeth. A number of issues may cause a child to not be able to close their mouth completely, which leads to increased drooling or dry mouth. Finally, a learner may require to be fed via a gastric or nasogastric tube, which requires special oral care to prevent excessive drooling, dryness, and mouth sores. The instructional steps assist the registered nurse working under the auspices of the school or program in professional judgement and accountability of delegation. Additional steps may be required depending on the learner’s health needs.

School health service delivery is able to help students prevent one of the most common chronic health issues throughout their lifespan: tooth decay.

Untreated tooth decay can lead to acute pain and localized infections (abscesses near the gumline) that can spread into facial spaces creating regional cellulitis that can have serious life-threatening consequences. Tooth decay causes more missed days of school than any other chronic health condition.

Oral health is essential to general health and well-being.

Tip

Oral care may trigger behaviors as a mechanism for the child to communicate. If this occurs, stop and try to utilize interventions you have been delegated to calm the learner. If the child is unable to return to a calm state, then document, try at a different time and notify the school nurse.

Steps

  1. Explain the Procedure
    1. Use a “Tell, Show, Do” approach when providing care.
    2. Explain what you are going to do before starting.
    3. Wash your hands and have or help the student wash their hands
  2. Have the student find a comfortable position and assist if possible
  3. Demonstrate with your own brush to help calm and reassure student.
  4. Apply toothpaste (recommended by the parent or family) to the brush that the parent has provide
    1. If you are using an electric toothbrush, read the instructions before you begin and guide the brush to the child’s teeth before switching it on (do not press too hard or scrub, let the electric brush do the work).
  5. Wet toothbrush
  6. Brush teeth gently in circular motions (the inside of the upper and lower teeth)
  7. Brush teeth gently in circular motions (brush the chewing surfaces with a back and forth motions)
  8. Gently clean the rest of the mouth
  9. Rinse mouth
  10. Rinse brush
  11. Store brush to air dry
  12. Wash your hands and have the student wash their hands
  13. Follow any additional steps unique to the student’s delegated care as instructed by the school nurse.
  14. Document the date, time, care you provided, student’s response to the care, your initials and signature.