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I'm excited to welcome you to the first nationally broadcast training program
dedicated entirely to the oral health of nursing facility residents. Never
before has this issue been given such wide exposure or this level of visibility.
The mouth is easy to assess if you think in terms of the 4 major components of
oral health that you are reviewing: the teeth, the gums, the soft tissue, and
any appliances the resident may have, such as dentures or partials. To look in a
resident's mouth, have a facility staff member, preferably a nurse or a CNA,
help the resident open their mouth and retract the resident's lips. I can hear
you now: "What did he say? Get the staff to do what?" Yes, I did say to get the
staff to help you. As a dental consultant during surveys, I have never been
refused help by nursing staffs to do this. Staff members have always done a good
job and have been willing to help. Remember, someone in every facility should be
familiar with looking in the mouths, because looking in the mouth is required to
properly assess a resident for the MDS and the care plan. Don't hesitate to ask
for staff's assistance.
I'd like to show you a video of how simple this process can be. I want you to
notice on the video the man retracting the lips of this resident. He's the
facility administrator, and I purposefully chose the first cut of this video to
further prove how well this can work by facility staff. As you'll see, he did a
very good job. Notice how he's retracting the lips, and we can see all the
structures in the oral cavity that we need to review. Once the lips are
retracted, you can look inside the resident's mouth and note your findings. A
flashlight, which works best, or a penlight can greatly improve your ability to
accurately assess the resident's oral condition. Most facilities have a light
you can use.
When viewing the oral cavity, make sure to review each of the 4 oral/ dental
health components of the resident's mouth: teeth, gums, soft tissue, and dentures
or partials. First, look at their upper and lower teeth, or dentures or
partials, if they are missing teeth. After you've observed the teeth, dentures
or partials in the mouth, have the resident, the nurse, or the CNA remove the
dentures or partials and look at them to see if they are broken or dirty. Once
they are removed, have the facility staff retract the lips again and continue.
Now look at their teeth, gums, tongue, cheeks, and palette.
This oral observation shouldn't take more than a few minutes and provides
crucial information to you as you investigate if the resident's needs are being
met. Make sure to record the time, date, and names of all the people present
when you perform your resident observation.