Easy Steps for Good Mouth Care

Good mouth care is important at the end of life or as an illness progresses. Oral health issues are common problems for many older adults, and keeping the mouth clean can help to make your loved one more comfortable and may help increase their appetite. It can also prevent dry mouth, bad breath, infections, and aspiration pneumonia. If your loved one needs help with mouth care (or can’t do it at all), follow these steps.

To Brush Teeth and Clean Mouth

• Gather supplies. You’ll need:
  • Glass of water or alcohol-free mouthwash
  • Nonsterile gloves (optional)
  • Washcloth (optional)
  • Soft toothbrush or foam swab (do not use lemon glycerin swabs unless instructed — they can increase dry mouth)
  • Nonabrasive toothpaste
  • Small, shallow bowl
• Ensure that your loved one is sitting up, not lying down — to keep them from choking. If they cannot be upright, it is important to ask your hospice nurse for special instructions.
• Explain what you are about to do. If your loved one is able, ask them to take a sip of water to moisten the mouth, or use a wet foam swab and gently moisten the mouth and lips.
• Put on gloves, if you wish. Have a washcloth ready to wipe your loved one’s mouth (let them hold the washcloth to use if they can).
• If your loved one wears dentures, remove and clean them. Brush with denture toothpaste using a soft brush. Allow the dentures to soak in water or a denture cleaner until your loved one is ready to wear them again; be sure to brush the dentures again they are worn.
• Use a soft toothbrush (or foam swab) and a small amount of toothpaste to gently brush the teeth, gums, and tongue. Be careful not to put the toothbrush too far in the back of the mouth because this can cause gagging.
• If your loved one’s teeth cannot be brushed, use a mouth rinse. Do not use over-the-counter mouth rinses with alcohol — they increase soreness and cause dryness. You can make a mouth rinse by stirring 8 ounces of lukewarm water with ½ teaspoon of baking soda and ¼ teaspoon of salt.
• Ask your loved one to rinse well and spit in the bowl. They should not swallow toothpaste or mouth rinse.

Preventing Problems

Cracked and dry lips can be painful. Be sure your loved one’s lips are kept moist so that they don’t need to lick their lips, which can increase chapping. If the skin on and around the lips is unbroken, you can use a moisturizer that has an oil base or petroleum jelly. If the lips have open areas, use only moisturizers that are water soluble. Apply the lip moisturizer every 2 hours or as needed.