[Dysphagia] Mouthwash for Oral Care Prerequisite for Free Water Protocal

[rehabstaff at graceworks.org (Rehabstaff)]

This is an update on the search for mouthwash to use for oral care in
rehab/extended care facilities.

 

The FDA has noted that mouthwashes containing Cetylpyridinium chloride
or Stannous fluoride both safe and effective as an antibacterial &
antiplaque.  Products containing hydrogen peroxide are noted as being
safe but the effectiveness has not yet been demonstrated.  Please feel
free to e-mail me for a summary of the report - this was privately
e-mailed to me by a member and I'd be happy to forward it to you.

 

There are over the counter mouthwashes that contain Cetylpyridinium
chloride, namely Breath Rx (approx cost $10) and Crest Pro Health - not
the whitening (approx cost $4).  Interestingly, I tried the Crest Pro
Health and if you follow the direction you may be left with a long
lasting slight bitter taste in your mouth for hours.  A few of the
resident's who trialed this noted this effect as well.  I'm guessing
that this may account for some decreased PO intake in these residents.  

 

The free (Frazier) water protocal oral care procedure that I currently
have recommends a 1.5% hydrogen peroxide mouthwash be used after oral
care.  This is also available over the counter in Colgate Peroxle
mouthwash (approx cost $11).  I do have residents that develop foaming
and those with diminished lingual movement are having difficulty
expelling this even when a staff member is simply swabbing the mouth
with a moistened toothette.  They are literally foaming at the mouth a
bit! :-)

 

I am wondering if anyone else is using mouthwashes containing these
products, especially as part of the oral care program with the free
water protocal.  My facility's purchasing department is still running
into some difficulty locating individual mouthwashes.  Sage makes a
product but it contains only 1.5oz.  I am currently asking select
resident's families to purchase the recommended mouthwashes on their
own.

 

We've been working on implementing the oral care and free water protocal
procedure since March.   The staff has stopped using thickened water to
do oral care so progress is being made!

 

Sonja Dragich M.A., CCC-SLP

Graceworks Lutheran Services

Rehabstaff at graceworks.org

 

 

 

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