LEVEL I – GRANT



TRINITY VALLEY COMMUNITY COLLEGE

ASSOCIATE DEGREE NURSING

RNSG 1216

PROCEDURE GUIDE AND CHECK-OFF SHEET

BRUSHING TEETH – Conscious Patient

Oral hygiene maintains the integrity of the teeth and gums. Brushing of the teeth prevents tooth decay and infection and stimulates circulation of the gums.

Delegation: This procedure may be delegated to unlicensed assistive personnel. The nurse retains the responsibility of the assessment.

| Procedure | Scientific Rationale |

|1. The following equipment is needed for this skill: | |

|toothbrush | |

|toothpaste | |

|cup of water | |

|basin | |

|dental floss | |

|towel | |

|gloves | |

|mouth-wash. | |

|Assist patient to a sitting or side lying position. |These positions decrease the risk of possible choking or aspiration. |

|Place towel under patient’s chin. |Prevents soiling of gown and bed linens. |

|Ask patient to open mouth and inspect mouth, teeth and gums. |Assessment will provide information for any problems, such as tooth decay,|

| |gum inflammation, halitosis, etc. |

|Moisten toothbrush and apply small amount of toothpaste. |Use of toothpaste prevents tooth decay. A small amount of toothpaste |

| |prevents possible aspiration. |

|6. Brushing the teeth: | |

|Have patient hold basin under chin. If unable to hold, the nurse |a. Prevents soiling. |

|will hold for patient. | |

|Hold brush against teeth at a 45-degree angle to the gum line. | |

| |A 45-degree angle aids in removing plaque and food from gum line. |

|Direct bristles from the gum to crown of tooth. | |

|Move the bristles from gum line up and down to the crow of each | |

|tooth. |A back and forth motion removes food from gum line and provides |

|Repeat until all outer and inner surfaces are cleaned. |stimulation of gums. |

| | |

|f. Clean biting surfaces by moving brush back and forth in |f. Aids in proper cleaning. |

|short strokes. | |

|7. Brush tongue gently with toothbrush. |Brushing the tongue can remove coating which can lead to halitosis. |

| |Brushing gently helps prevent gagging. |

|8. Have patient rinse with water or mouthwash. |Rinsing loosens food particles and removes already loosened particles. |

|9. Flossing the teeth: | |

|Wrap the ends of floss around the third finger of each hand. |a. Flossing removes plaque and food particles that collect between teeth |

| |and gums which brushing doesn’t reach. |

|Using a sawing motion, start with back lower teeth and floss up | |

|and down. Move from one side of the mouth to the other. | |

|Repeat above procedure, flossing the upper teeth using a new | |

|piece of floss. | |

|Have patient rinse mouth. | |

| |d. Rinsing removes loosened food particles. |

|Offer the patient mouthwash. Instruct the patient to swish the |Mouthwash freshens breath; asking about preferences allow for patient |

|mouthwash inside the mouth, gargle (if desired), and spit into |control and facilitates cooperation. |

|emesis basin. | |

|Document assessment of teeth, gums, and oral mucosa. |All data must be entered in patient’s record. |

|Report any abnormal data to the appropriate personnel. |Any abnormal finding must have a corresponding nursing action. |

N:ADN/ADN Syllabus/CBC Curriculum/Level I/1216/Performance Checklist for Basic Skills - Brushing Teeth Reviewed 04/16

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