HealthInfo Canterbury
Carer's guide to mouth care
Tā te kaimanaaki aratakinga ki te tiakitanga ā-waha
This page is about caring for someone who is ill, but not terminally ill (dying). If you are caring for someone who is terminally ill, see Mouth care in palliative care.
When people cannot keep their mouths clean and clear, they need someone to do this for them. This may be because they are very ill or have a progressive neurological disorder. Mouth care important because it reduces the risk of infections in their mouth.
A healthy mouth has an intact lining and is clean, moist and pain-free. An unhealthy mouth can be very sore, dry or infected. It can have a huge impact on the quality of life of someone who is unwell or has a progressive disorder. For example, it can make it difficult for them to eat or drink or to communicate with others.
Anyone, including whānau (family) and caregivers, can perform this mouth care.
How to give mouth care
When you are providing mouth care for someone, it is most important to look inside their mouth once a day. You should look for redness, swelling, sores, white patches, bleeding, pain or dryness. Tell their nurse or doctor if there are any changes.
Mouth care should happen after every meal or snack. If the person is not allowed to eat (nil by mouth, or NBM), carry out mouth care every two hours, or even more often if needed.
When you are using a swab, make sure you do not poke it too far back on the person's tongue, as this may make them gag.
Cleaning the person's mouth
Before you start, make sure the person is sitting up, or lying on their side. This protects their airway.
Make sure you have:
- 2 or 3 mouth swabs or a super soft toothbrush
- mouthwash solution (the nurse or pharmacist will advise you what to use)
- a toothbrush and toothpaste (if the person you are caring for has teeth). Only use a pea-sized amount of toothpaste and no water. This minimises the amount of foam and increases the cleaning action of the toothpaste.
What to do:
- Dip the swab in mouthwash.
- Squeeze excess fluid from the swab.
- Wipe one area of the mouth with the swab.
- Throw away the used swab.
- Repeat in the next area of their mouth.
Clean each area of the mouth with a new swab until it comes out looking clean. Areas to clean are:
- the top gum
- the bottom gum
- the roof of the mouth
- under the tongue
- the surface of the tongue
- inside the cheeks.
Dry mouth
Having a dry mouth can be very uncomfortable. The person you are caring for may be too unwell to keep their mouth moist. If so, you can use swabs dipped in water to moisten their mouth and lips every one to two hours.
You can also use oral moisturisers. These are available from your pharmacy.
If the person is drowsy or unconscious, having something placed in their mouth can be a shock. Familiar fluids and the touch of a family member can lessen the shock. Avoid iced water, as this can be a shock, especially if someone has sensitive teeth.
Take particular care if their mouth is painful or has ulcers. Consider using choline salicylate gel (Bonjela). You can buy this from a supermarket or pharmacy. Make sure you keep their lips moist with petroleum jelly (Vaseline) or lip salves.
Sore mouth
If the person's tongue becomes sore, red or covered with a fuzzy coating, they may have oral thrush (candida). Tell their doctor, as this is easy to treat with antifungal drops. Regularly cleaning and moistening their mouth can help to prevent this.
Written by community speech-language therapists. Adapted by HealthInfo clinical advisers. Last reviewed July 2023.
Sources
Review key: HIMCA-388575
