Oral Care and Denture Care

When & Why?

Maintain oral health, comfort, nutrition, and dignity.
Poor oral hygiene may contribute to:

• Tooth decay and gum disease.
• Pain and difficulty eating.
• Bad breath and decreased self-esteem.
• Increased oral bacterial burden.

Before You Start

• Check the care plan, swallowing precautions, and level of assistance.
• Explain the procedure and provide privacy.
• Perform hand hygiene and use appropriate PPE.
• Gather toothbrush, toothpaste, water, towels, and denture supplies as needed.
• Position the resident upright when possible.

Steps

Natural Teeth

1. Help the resident brush at least twice daily, as appropriate.
2. Use a soft toothbrush and suitable toothpaste.
3. Clean outer, inner, and chewing surfaces.
4. Gently clean the tongue and oral tissues as appropriate.
5. Assist with rinsing and spitting if safe.
6. Clean and store supplies.

Dentures

1. Ask the resident to remove dentures; assist if necessary.
2. Place a towel or protective barrier in the sink to prevent breakage.
3. Clean dentures using an appropriate denture brush and cleaner.
4. Rinse thoroughly according to product instructions.
5. Clean the resident’s gums, tongue, and mouth.
6. Replace dentures or store them in a labeled container with the recommended solution.

Residents With Swallowing Difficulties or Aspiration Precautions

1. Review the care plan for swallowing restrictions, permitted positioning, oral-care products, and required assistance.
2. Position the resident upright or side-lying as directed by the care plan.
3. Use approved oral-care supplies appropriate to the resident’s swallowing ability.
4. Avoid offering water or mouthwash for rinsing when the resident cannot safely swallow or spit.
5. Use only the prescribed amount of oral-care product and avoid excess fluid.
6. Request trained nursing assistance when suction-assisted oral care is required and outside your assigned competency.
7. Stop care and obtain help if the resident develops coughing, choking, breathing difficulty, or other signs of distress.
8. Report and document concerns according to facility policy.

Important: NPO status does not eliminate the need for oral hygiene. Follow the individualized oral-care plan and do not provide oral fluids or rinses contrary to swallowing restrictions.

Safety & Observations

• Follow aspiration precautions and modified oral-care procedures for residents with swallowing difficulties.
• Avoid forcing the mouth open.
• Never use hot water on dentures.
• Use denture-specific cleaning products unless directed otherwise.
• Check for loose dentures and damaged teeth.
• Stop and report significant pain or bleeding.
• Do not assume a resident can safely rinse, spit, or swallow because they are awake.
• Never give oral rinse water contrary to NPO orders or swallowing precautions.
• Do not independently perform suctioning unless trained, authorized, and assigned under facility procedures.
• Oral hygiene remains important for residents receiving tube feeding or restricted oral intake.

What Should I Remember?

• Natural teeth and dentures both require regular cleaning.
• Denture removal and insertion must be gentle.
• Label and store dentures safely.
• Residents who cannot rinse or spit need an individualized oral-care approach.

Related

• Daily Personal Care & ADLs
• Standard Precautions
• Communication Accommodations

Practice

• Studied
• Observed
• Practiced
• Passed checkoff

Sources

• CNA Module 8 — Oral Hygiene
• CDC — Oral Health in Healthcare Settings to Prevent Pneumonia Toolkit
• AHRQ — Interventions to Prevent Nonventilator Hospital-Acquired Pneumonia
• Facility dysphagia, NPO, oral hygiene, and suctioning procedures (verify at clinical site)

Flashcards

Why is oral care important for dependent residents?03-application / clinical-skills

Answer

It supports comfort, oral health, and infection prevention.

What is important when caring for removable dentures?03-application / clinical-skills

Answer

Handle gently, clean as directed, and store safely in a labeled container.

Should oral hygiene be omitted when a resident is NPO?03-application / clinical-skills

Answer

No. Follow the individualized oral-care plan without violating intake restrictions.

What should a CNA do if a resident cannot safely rinse or spit?03-application / clinical-skills

Answer

Avoid oral rinsing and follow the prescribed aspiration-safe oral-care procedure.