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[Dysphagia] Oral hygiene
Hi Gerriann,
We have just finished the first phase of developing an Oral Care
Protocol for our District Health Board. This is a precursor to
introducing the Frazier Water Protocol. As part of our Lit review we
found the following article particularly useful:
Garcia, R. 'A review of the possible role of oral and dental
colonization on the occurrence of health care-associated pneumonia:
underappreciated risk and a call for interventions' Am J Infect Control.
2005 Nov;33(9):527-41
The main recommendations are:
1. Use non-alcohol based mouthwashes (as these are drying on mucosa).
Recommend hydrogen peroxide based products
2. For severely impaired oral hygiene use Chlorhexadine solution (the
one we get is Rivacol, 0.2% and produced specifically as mouthwash).
They don't recommend extended use, but then hopefully if the patient is
treated and given regular oral care they won't be categorised as
'severe' for long and can go back to just regular brushing and
mouthwashes.
3. Use water based mouth and lip moiturisers (not oily ones)
4. Always use toothbrushes on any natural teeth (even if only one left,
swabs not enough)
5. Toothpaste containing sodium bicarbonate to break down secretions
Hope this helps,
Helen
Helen Williams
Speech Language Therapist
Wellington Hospital
NZ
Ex 5082
Pg 2870
-----Original Message-----
From: dysphagia-bounces at b9.com [mailto:dysphagia-bounces at b9.com] On
Behalf Of gerriann jackson
Sent: Wednesday, 21 February 2007 12:49 p.m.
To: kathleen wright; Sharon Richards; dysphagia at b9.com
Subject: Re: [Dysphagia] Oral hygiene
Can someone provide me with a reference to literature that says that 50%
h2o2 is toxic to the oral mucosa? I've seen it referenced several times
on the list, but all the research that I ahve read says the
cholorhexedrine or any alcohol based cleanser is the one to avoid In
the last year, we have changed our oral care policies and now use 50%
h2o2 or the Sage products with peroximint.
Thanks,
Gerriann
-----Original Message-----
From: dysphagia-bounces at b9.com [mailto:dysphagia-bounces at b9.com]On
Behalf Of kathleen wright
Sent: Tuesday, February 20, 2007 11:35 AM
To: Sharon Richards; dysphagia at b9.com
Subject: Re: [Dysphagia] Oral hygiene
I am using the Water Protocol under very controlled conditions with one
young man who has profound mental retardation. He can have as much thin
water to drink as he wants, after careful oral hygiene. The oral
hygiene program uses a toothbrush and a pea-size piece of toothpaste,
and then uses the toothbrush dipped into antibacterial mouthwash,
brushing all intraoral surfaces. He has done very well with this
protocol, for over two years, and I would like to see it expanded to
giving him a cup that is kept constantly filled with water, to drink
whenever he wants, all day long, in all settings.
----- Original Message -----
From: "Sharon Richards" <noahsark322 at yahoo.com>
To: <dysphagia at b9.com>
Sent: Tuesday, February 20, 2007 11:25 AM
Subject: [Dysphagia] Oral hygiene
> In regards to the Water Protocol...I would love information on the
> effectiveness of adequate daily oral hygiene (brushing, flossing,
> rinsing) with long-term residents as opposed to the peroxide rinses,
> which I have read can have ill-effects on the oral mucosa.
>
> ---------------------------------
> Food fight? Enjoy some healthy debate
> in the Yahoo! Answers Food & Drink Q&A.
> _______________________________________________
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>
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