ORAL CARE

Non-medical and Medical Responders

Good oral hygiene reduces oropharyngeal colonization which is associated pneumonia. Pneumonia can be acquired regardless of whether or not the casualty is intubated. Casualties who are conscious should brush their teeth a minimum of every 12 hours. For unconscious casualties, perform oral care at least every 4 hours.7 Ensure some type of suction is available (e.g., manual suction device, syringe with IV tubing).

Supplies

- Minimum: Gloves, lip moisturizer (i.e., petroleum jelly), tongue depressor, tape, self-made suction (60 mL syringe with tubing attached), gauze, and water
- Better: Gloves, gauze, lip moisturizer, tongue depressor, tape, hand-held suction, toothbrush, and toothpaste (use sparingly)
- Best: Gloves, gauze, lip moisturizer, tongue depressor, tape, commercial oral cleansing and suction system, and wall suction or suction machine

Guide for oral care using gauze

- To keep the casualty’s mouth open, make a padded tongue depressor by wrapping gauze around one end of it and securing with tape. Use foam tape, if available, for additional padding. Ensure depressor is only inserted just past the casualty’s teeth/gums.
- Wrap a gauze around a gloved finger and hold firmly with the rest of hand.
- Moisten the gauze with mouthwash or water (ensuring not to oversaturate) and gently clean the teeth and mouth cavity. The gums, hard palate, and tongue should also be cleaned.
- Clean teeth and oral cavity for approximately 1 minute. Multiple gauze swabs may be needed depending on the level of contamination in the mouth.
- Use suction as needed to clear secretions.
- Apply lip moisturizer.