Prepared by :SIG, Dermatology Nursing

IADVL

CONT……Good oral hygiene has health and social

benefits, and will help patients recover from illness

ImportanceSome dermatology diseases may only involve

the oral cavitySome disorders may involve the oral cavity

along with skin Some systemic disorders may involve the oral

mucosa as well

CONT….Oral nursing care is mostly important in

disorders likePemphigusSteven Johnson SydromeToxic epidermal necrolysisSevere oral candidiasisSever herpetic gingivostomatitisExtensive aphthous ulcers

Aphthous ulcer

Pemphig vulgaris

Steven Johnson syndrome

Toxic epidermal necrolysis

http://www.eijd.org/viewimage.asp?img=IndianJDermatol_2013_58_5_406_117319_f2.jpg

Role of nursesIn patients who are able to carry out oral

care themselves - should facilitate or prompt patients to carry out themselves at appropriate times (morning, night, after meals or after vomitting, more frequent if required)

In bed ridden patients or who are not able to do themselves nurses should undertake oral care

Oral assessmentGain consentWash handsWear gloves and apronMaintain privacy.Assesst the oral cavity for the oral hygiene,

dental hygiene, ulcers, growths, etcUse of torch, tongue depressorRecording of the problem

Oral careGain consentAssemble equipment – toothbrush, toothpaste,

clothing protection, glass of water for rinsing mouth, receiver, tissues, medications

Position of patient: upright ( if patient needs to lie flat special care to avoid choking – turn patient’s head to the side and suction equipment if available)

If patient can tolerate – brush the inner, outer and biting surfaces of the teeth with wet toothbrush with a small amount of toothpaste. Use a gentle rotational movement

Oral care – cont.If patient can’t tolerate the use of toothbrush

(e.g extensive involvement with tenderness SJS/TEN)- mouthwash can be used instead

Allow the patient to take mouthfuls of water, rinse the mouth and spit into the receiver. Use tissues to dry around the mouth

Apply the medicine prescribed by the physician gently with a ear bud over the lesions

Oral care – .cont.Apply moisturizer to the patients lipsDocument the care you have given

How often should oral care be carried out???As often as necessaryBrushing the teeth at least twice dailyApplication of topical anaesthetic gel

(containing Benzocaine) 15-20 minutes before each feed

Rinsing the mouth with antibacterial rinse after each feeding ( if patient has tenderness anaesthetic rinse may be added)

Applying antifungal/antibacterial creams/gels/lotions after rinsing