ORAL HYGIENE AND HEALTH EDUCATION

SN: I’ve ended research for my term paper, and I’d like to check all this with you. But I don’t know what to begin with and how to organize my thoughts.

RN: Maybe you should introduce your work on the importance of oral hygiene in relation to health issues. Therefore, some anatomophysiology notions would be a good start.

SN: My first chapter would be dealing with how the bacteria that are present in the mouth can provoke infectious foci, and spread through endodontic or periodontal pathways if teeth are not regularly cleaned.

RN: Yes. And the fact that the infectious process is favored by sugar-rich diet, the frequency of ingestion of carbohydrates, smoking and individual factors, like low salivary production, genetic predisposition and socioeconomic status.

SN: You mean the role of food, and also social interaction, in the whole process?

RN: Exactly. And from here, you can link your second chapter to pathologies. Therefore, what would you start with?

SN: I guess it would be logical to start with the pathologies of the odonte, for example the carious disease, the cervical wear and tear injuries, to carry on with the pathologies of the periodontium, like gingivitis, parodontitis and the periodontal abscess. And I would like to have a chapter on oral infections that if not treated, mainly in patients already having cardiac disorders, would cause cardiopathologies.

RN: You also should tackle the factors that contribute to trigger oral pathologies, for instance the lack of oral hygiene and daily diet and habits like the use of tobacco, alcohol and too much sugar in food, as I said earlier, oral dryness, motor disorders which would disable the person from using a toothbrush, and cognitive and mental disorders which would be an obstacle to perceiving the importance of hygiene.

SN: So, in this sense, I should have a chapter on holistic care, shouldn’t I?

RN: For sure. And the psychological approach should be taken into account, and also what we refer to as care perceived as “threatening” and the caregiver’s posture.

SN: How does this fit in, in nursing care, as of course I need to deal with that?

RN: Apart from the fact that the mouth is seen as a route for food intake, it has a social function, like in communication, but also in sexual relations. Therefore, it has to be considered in its physical, psychological, esthetic and self-esteem perspectives. As for the perceived “threat”, patients might feel a sort of « intrusion » inside their bodies, related to some kind of past fear, fragility, handicap or age.

SN: But then again, what about the proper nursing role and care follow-up?

RN: Caregivers should be kind and understanding, and try to build a trust-relationship for the patient adhere to care. They should also be knowledgeable in the patient’s overall health condition, and see into the existence of possible dental pain, and therefore inspecting the patient’s mouth with the naked eye, and give advice in case of dry, smelly or dirty mouth, of mycosis or bleeding, sores, mucitic ulcerations or herpes. And, of course, the best way for teeth brushing and its importance for the general health, which will point back again to the main objective of your work, that is patient education.