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Daily oral care in home care

The third process in helping to improve an older person's oral health, is putting the oral health care plan into action by supporting the delivery of daily oral care.

Nurses and care workers play a key role in encouraging older people to maintain good oral health. Effective daily oral care is one of the best ways of managing and/or preventing oral health problems.

See below for the following:

Self learning activities

Improve your oral health knowledge and skills by working through the following self learning package. The package is based on five activities. Each activity steps you through a series of learning outcomes based on reading some information, watching an audio visual resource and answering a reflective question work sheet.

Before you begin

First of all check what you already know using the pre-quiz: What do you already know? (PDF 425KB). This will help check what you already know, what you need to learn more about and what you don’t know.

Activity 1 

Better Oral in Home Care activity (PDF 2565KB)

Related video: care workers - oral health heroes video

Activity 2

Dementia and oral care activity (PDF 2343KB)

Related video: dementia and oral care video

Activity 3

Understanding the mouth (PDF 2209KB)

Oral health assessment quiz

Related video: It starts with the mouth video and the oral health assessment demonstration

Activity 4

Care of natural teeth (PDF 2330KB)

Related video: care of natural teeth video

Activity 5

Care of dentures (PDF 2421KB)

Related video: care of dentures video

Once you have finished

Check what you have learnt using the post-quiz: What do you know now? (PDF 2211KB). This quiz will show you what you need to revise to improve your level of understanding.

Oral health information

Good oral health is essential for healthy ageing

Good oral health is essential for healthy ageing (PDF 2270KB) provides a summary of how poor oral health can affect an older person’s quality of life, overall health and wellbeing.

A healthy mouth will improve overall health and wellbeing

A healthy mouth will improve overall health and wellbeing (PDF 2869KB) shows a visual representation of the mouth as a portal for disease with tooth decay and gum disease sharing links with medical conditions such as cardiovascular, cerebrovascular and respiratory diseases.

It takes a team approach

While older people may or may not visit a dental professional on a regular basis, they do see a range of health workers who are responsible for assessing and monitoring their health status as well as assisting with personal care. It takes a team approach (PDF 2270KB) encourages everyone share the responsibility for implementing one or more of the following four key oral health processes:

  • oral health assessment
  • oral health care planning
  • oral health care
  • dental treatment.

Good oral health begins at home

Oral care is often taken for granted but is more difficult to achieve when an older person is compromised by physical frailty, cognitive impairment, functional dependence, chronic disease and polypharmacy. Good oral health begins at home (PDF 2210KB) describes a preventative primary oral care approach which addresses:

  • the daily care of natural teeth and dentures
  • relief of dry mouth
  • tooth friendly eating
  • seeing a dental professional
  • quitting smoking.

This is a simple way to effectively manage oral conditions commonly experienced by older people.

Care of natural teeth

Advances in dentistry and water fluoridation have resulted in increasing numbers of people retaining their natural teeth well into old age. Importantly tooth loss due to tooth decay and gum disease is generally due to poor oral health care rather than directly related to ageing. Care of natural teeth (PDF 4982KB) describes the instructions and rationale for the care of natural teeth.

Care of dentures

Older people who wear dentures are at risk of fungal infections such as denture stomatitis. Oral infections can be attributed to:

  • wearing dentures overnight
  • poor cleanliness of dentures
  • denture plaque
  • the permeability of acrylic denture resin
  • diet and pre-existing general health factors such as diabetes.

Care of dentures (PDF 8435KB) describes the instructions and rationale for the care of dentures.

Relief of dry mouth

Dry mouth is an important oral health consideration as it impacts on a person's quality of life by:

  • increasing the risk of oral infections and aspiration pneumonia
  • causing a burning sensation, soft tissue changes including cracked, dry lips, bad breath, and intolerance to spicy foods
  • affecting a person's ability to speak, taste, chew and swallow food (especially dry foods) easily
  • impacting a person's ability to wear dentures comfortably.

Relief of dry mouth (PDF 3308KB) describes the instructions and rationale for relief of dry mouth.

Tooth friendly eating

Saliva clears food from the mouth and neutralises acid produced by bacteria in dental plaque.

It is important to remember that it takes:

  • a healthy mouth about twenty minutes for saliva to neutralise the mouth
  • a dry mouth twice as long
  • frequent snacking exposes teeth to continuous acid attack. 

Tooth friendly eating (PDF 4486KB) explains how tooth friendly foods and the drinking of plain tap water after eating helps reduce the adverse effects of acid attack.

Seeing a dental professional

Older people who visit a dental professional on a regular basis are more likely to benefit from early detection and treatment.

Known reasons for older people not seeing a dental professional includes:

  • physical and cognitive impairment
  • transport
  • past negative experiences
  • anxiety
  • cost
  • the belief that poor oral health is a natural part of growing old.

Many older people see a dental professional only when they have an urgent painful problem. Seeing a dental professional (PDF 4111KB) describes routine oral health assessment and how to assist older people to see a dental professional.

Quit smoking

Smoking is recognised as resulting in more disease than any other single risk factor. Many medical and oral conditions caused by smoking result in years of debilitating health issues. Smoking is a known cause of gum disease and oral cancers. Quit smoking (PDF 3356KB) describes the effects of smoking on oral health and the benefits of quitting.

Dementia and oral care

Some older people, especially those suffering dementia, may behave in ways that make it difficult to provide oral care. To encourage an older person’s independence and get the best outcome for their oral health, it is important to think about their individual needs and how they can be supported to participate in self-care.

Dementia and oral care (PDF 5641KB) provides an overview of how this can be achieved through:

  • effective communication
  • choosing the right environment
  • promoting participation
  • responding appropriately to changed behaviours.

Reporting oral health changes

Whether you are assisting with personal care or with domestic duties, you are in a great position to notice changes in a person’s oral health and report these to the care coordinator.

Reporting oral health changes (PDF 5735KB):

  • provides a simple STOP, CHECK, ACT approach to thinking about oral health changes
  • describes the common oral health conditions experienced by older people
  • gives an oral health reporting guide to help you identify what should be reported on.

Multimedia resources

Care workers – oral health heroes

This is a motivational resource highlighting the important role of home care workers in supporting and encouraging older people to maintain good oral health. It provides key oral health messages and tips for successful dental visits for clients.

Dementia and oral care

This is an instructional resource demonstrating how to encourage a person with dementia to participate in oral care. It breaks oral care into six simple steps.

It starts with the mouth

This is an animated resource demonstrating what happens in the mouth when food is eaten and describes the impact of an acid attack. It goes on to describe how saliva and fluoride protect natural teeth. It introduces the concept of ‘tooth-friendly’ eating, explains the simple six question oral health assessment tool and the importance of having a dental check-up.

Care of natural teeth

This is an instructional resource demonstrating techniques used to clean another person’s natural teeth. It explains the importance of oral health and its links to general health and provides key oral health messages.

Care of dentures

This is an instructional resource demonstrating how to remove and clean dentures.

Oral health assessment demonstration

This demonstration shows the technique of how to perform an oral health assessment. It takes a step by step approach describing what to look for in relation to each of the eight oral health categories being assessed.

Oral health self learning quiz

The oral health self learning quiz is designed to test your knowledge of the common oral health conditions experienced by older people. It steps through the eight oral health categories using a series of examples to prompt an assessment of whether the example is assessed as healthy, changes or unhealthy. A healthy or changes assessment can be managed by appropriate oral health care planning. An unhealthy assessment indicates the need for a dental referral.

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