Unable to Swallow Oral Care Performance Checklist

Oral Care for the Client who is Unable to Swallow or is Unconscious

• Check care plan for direction and client needs. Perform hand hygiene. Explain the procedure to the client. Assess the client’s status before undertaking the activity. Provide for privacy.
• Collect and prepare supplies for oral care. Raise bed to comfortable height, lower side rail.
• Apply disposable gloves. Check mouth for abnormalities.

Positioning:

• Unconscious person on side with head turned well toward dependent side with head of bed lowered unless contraindicated. Place a kidney basin under the person’s chin.
• For a conscious person who is unable to swallow, assist to an upright sitting position or side lying position.
• Place towel under client’s head and chin.
• For an unconscious person: carefully separate upper and lower teeth/gums with padded tongue blade or commercial spacer.

Cleaning

• Clean mouth using a soft brush dipped in mouth rinse. Brush teeth or massage gums at a 45⁰ angle. Brush tongue and palate. Dry teeth/tongue/palate with gauze.
• Apply a thin layer of water-soluble lubricant or client’s lip balm to lips. Rinse toothbrush and air-dry.
• Reposition client and provide for safety and comfort. Perform hand hygiene. Tidy area.
• Report and record actions and observations according to agency policy.