Critical care nursing
ORAL AND DENTAL HEALTH NURSING
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| 4.ORAL AND DENTAL HEALTH NURSING
Oral health is the state of the mouth, teeth and orofacial structures that enables individuals to perform essential functions such as eating, breathing and speaking, and encompasses psychosocial dimensions such as self-confidence, well-being and the ability to socialize and work without pain, discomfort and embarrassment. Oral health varies over the life course from early life to old age, is integral to general health and supports individuals in participating in society and achieving their potential. Oral health nursing is a field of nursing that focuses on promoting and maintaining oral health. In oral health nursing, nurses play a crucial role in preventing dental diseases and promoting good oral hygiene practices. They educate patients on proper brushing and flossing techniques, provide preventive treatments like fluoride application, and assist in dental procedures. They also assess oral health conditions, identify risk factors, and collaborate with other healthcare professionals to develop comprehensive care plans. Dental health nursing is a branch of nursing that specializes in promoting and maintaining oral health. It involves providing care and education related to dental hygiene and assisting with dental procedures. In dental health nursing, nurses work closely with dentists to provide comprehensive care to patients. They assist in dental procedures, educate patients about oral hygiene practices, and promote preventive measures such as regular check-ups and cleanings. Dental health nurses also play a vital role in addressing dental emergencies, managing pain, and providing post-operative care. IMPORTANCE OF ORAL HYGIENE IN OVERALL HEALTH 1.Physical Health: Poor oral hygiene can lead to various dental problems, including tooth decay, gum disease, and infections. These oral health issues can have adverse effects on physical health, such as chronic pain, difficulty eating and speaking, and increased risk of systemic diseases like cardiovascular disease and diabetes. 2.Nutritional Intake: Oral health is closely linked to nutrition. Maintaining healthy teeth and gums allows individuals to have a proper diet by being able to chew and digest food effectively. Poor oral health such as missing teeth or painful gums, can restrict food choices and lead to nutritional deficiencies. Good oral health enables individuals to consume a balanced diet, promoting overall well-being. 3.Social and Psychological Well-being: A healthy smile enhances self-esteem and confidence, enabling individuals to engage in social interactions without feeling self-conscious about their oral appearance. Poor oral health, on the other hand, can lead to embarrassment, social isolation, and reduced quality of life. ROLE OF DENTAL AND ORAL HEALTH NURSES IN HEALTH CARE In the community, nurses and other multidisciplinary teams can address strategies to improve dental health, reduce pain, provide proper nutrition, and promote optimal general and psychosocial well-being. Dental and oral health nurses play a crucial role in healthcare by focusing specifically on the prevention, promotion, and treatment of oral health. Here are key aspects of their role: A. Preventive Care: -Educating patients on proper oral hygiene practices. -Conducting screenings for early detection of dental issues. -Promoting preventive measures like fluoride treatments and sealants. B. Patient Education: -Providing information on maintaining oral health and preventing dental diseases. Instructing patients on proper brushing, flossing, and dietary habits. C. Clinical Assistance: -Assisting dentists during examinations and procedures, Taking and developing dental X-rays. Managing infection control procedures to ensure a safe clinical environment. D. Health Promotion: Conducting community outreach programs to raise awareness of oral health, Participating in initiatives to promote overall health through oral care. E. Pediatric Dentistry: Specializing in dental care for children, addressing unique pediatric dental needs and Collaborating with parents and caregivers to establish good oral health habits in children. F. Specialized Procedures: Admiinistering topical anesthetics and fluoride treatments and assisting in the application of orthodontic devices. G. Screening for Systemic Diseases: Identifying oral manifestations of systemic health issues and Colllaborating with other healthcare professionals to address holistic health concerns. H. Patient Advocacy: Advocating for patients' oral health needs within the healthcare system and ensuring that patients receive appropriate and timely dental care. I. Emergency Care: Providing immediate care for dental emergencies and offering guidance on managing oral health issues between dental appointments. J. Continuing Education: Engaging in ongoing professional development to stay informed about advancements in dental and oral health care. Sharing updated knowledge with colleagues and the community. K. Counseling and Support: Offering emotional support and counseling to patients, particularly those with dental anxiety; Collaborating with patients on treatment plans and lifestyle modifications for improved oral health. L. Free oral Health checks: These can help detect tooth problems early on and prevent them from worsening. M. Brushing and Flossing Demonstration: Dental and oral health nurses contribute significantly to the overall healthcare system by promoting preventive measures, addressing oral health issues, and supporting patients in achieving optimal oral health.fa COMMON DENTAL AND ORAL HEALTH CONDITIONS 1.DENTAL CAVITY (CARIES): Dental Cavities are permanently damaged areas in the hard surface of your teeth that develop into tiny openings or holes. Cavities, also called tooth decay or caries, are caused by a combination of factors, including bacteria in your mouth, frequent snacking, sipping sugary drinks and not cleaning your teeth well. 2. PERIODONTAL DISEASES: They include; a. Gingivitis: It is a painful inflamed swollen gum. Usually the gums bleed in response to light contact. It is a reversible form of inflammation of the gingiva, that is, mild form of periodontal disease. It is associated with poor oral hygiene: food debris, bacterial plaque, and calculus (tarter) accumulate. Gum also swell in response to normal processes such as puberty and pregnancy with certain medications like (phenytoin(Dilantin) calcium channel blockers cyclosporine (neoral) or with a deficiency in the immune system (that is AIDS) or nutritional status. b.Necrotizing Gingivitis Trench Mouth: it is a grey white pseudo-membranous ulcerations affecting the edges of the gums, mucosa of the mouth, tonsils and pharynx, halitosis, painful bleeding gums, swallowing and talking are painful. It is caused by progressive painful bacterial infection related to poor oral hygiene, lack of access to dental care, inadequate rest over work, emotional stress, smoking and poor nutrition. c. Herpetic Gingivostomatitis: It is characterized by burning sensation by the appearance of small vesicles 24 to 48 hours later; vesicles may rupture, forming sore shallow ulcers covered with a grey membrane. The nurse should apply topical anesthetics as prescribed; may need opioids if pain is severe. Saline or 2 to 3% hydrogen peroxide irrigations. Antiviral agents such as acyclovir may be prescribed. It is caused by herpetic simplex viral infection occurs most frequently in people who are immunosuppressed. May occur in other infectious processes such as streptococcal pneumonia, meningococcal meningitis, and malaria. d. Periodontitis: People who experience this have little discomfort as onset may have bleeding infection, gum recession, loosening of teeth later in the disease tooth loss may occur. It is caused by deep chronic inflammation of the gingiva. It may result from untreated gingivitis, poor or inadequate dental hygiene, and inadequate diet, contribute to it's development. e. Dental Plaque And Caries: Tooth decay is an invasive process that begins with the action of bacteria on fermentable carbohydrates in the mouth which produces acid that dissolves tooth enamel. Despite the fact that tooth enamel is the hardest substance in the human body, caries and dental disease can occur for several reasons. Dental decay begins with a small hole usually in a fissure (a break in the tooth enamel) or in an area that is hard to clean, if left unchecked the decay extends into the Dentin. because dentin is not as hard as enamel, decay progresses more rapidly and in time reaches the pulp of the tooth. In general, dental decay can occur in anyone. Risk factors for periodontal diseases include, Age, Smoking/Tobacco Use, Genetics, Medications,Clenching or Grinding Your Teeth, Other Systemic Diseases, Poor Nutrition or Obesity. 3.TOOTH SENSITIVITY: Tooth sensitivity, also known as dentin hypersensitivity, is a common dental problem characterized by a sharp, transient pain in response to various stimuli such as hot, cold foods and drinks, sweet or acidic foods, cold air or activities like brushing.Tooth sensitivity primarily results from the exposure of dentin, the inner layer of the tooth, which contains microscopic tubules. Various factors contribute to dentin exposure, including enamel erosion, gum recession, tooth decay, cracked or chipped tooth, a worn filling, or gum disease, teeth grinding and tooth wear. 4.ORAL CANCER: Oral cancer, also known as mouth cancer, refers to the uncontrollable growth of cancerous cells in the oral cavity or the oropharynx. The oral cavity includes the lips, tongue, cheeks, gums, and the roof and floor of the mouth. The oropharynx extends to the back of the mouth, including the tonsils, soft palate, and the throat. Several factors increase the risk of developing oral cancer, including: tobacco use, alcohol consumption, sun exposure, diet, age, gender, genetics and some diseases like human papilloma virus (HPV), hepatitis. The Importance of Oral Hygiene 1.Oral hygiene is not just about a bright smile; it's crucial for your overall health. 2.Poor oral health can lead to systemic conditions, including heart disease and diabetes. 3.Maintaining good oral hygiene helps you prevent dental problems and contributes to your general well-being. Having the right tools is the first step to effective oral hygiene. So therefore, the tools needed include: a toothbrush, toothpaste, and dental floss. Choose a soft-bristle toothbrush to avoid damaging your teeth and gums. Important actions to be taken to maintain oral hygiene include: a.Brush your teeth at least twice a day: once in the morning and once before bed.This routine helps remove plaque buildup and prevents tooth decay and gum disease. b.Spend a full two minutes brushing your teeth. c.Avoid brushing immediately after consuming acidic foods or drinks: Acidic substances can weaken enamel, and brushing immediately can cause enamel damage.Wait at least 30 minutes before brushing after consuming acidic items. Dietary advice for maintaining oral Health Eating a well balanced diet is imperative to maintaining good oral health. It is helpful to supplement the diet with a good quality multivitamin. The best food choices include cheeses, chicken or other meats, nuts, and milk. These foods are thought to protect tooth enamel by providing the calcium and phosphorus needed for remineralization. Finishing a meal with cheese or milk will neutralize intra-oral acid. Other food choices include firm/crunchy fruits (for example, apples and pears) and vegetables. These foods have a high water content, which dilutes the effects of the sugars they contain, and stimulate the flow of saliva which helps protect against decay by washing away food particles and buffering acid. Acidic foods, such as citrus fruits, tomatoes and lemons, should be eaten as part of a larger meal to minimize the acidic environment to which your teeth and mouth must be exposed. The best beverage choices include water (especially fluoridated water), milk, and unsweetened tea. Consumption of sugar-containing drinks should be limited. Drink Water: Water helps wash away food particles and bacteria, and it often contains fluoride, which strengthens teeth. Practice Good Oral Hygiene: While diet is important, don't forget to brush your teeth at least twice a day, floss daily, and visit your dentist for regular check-ups and cleanings. Remember that a balanced diet, combined with proper oral hygiene practices, is essential for maintaining good oral health. INFECTION CONTROL IN DENTAL SETTINGS Infection control in dental nursing is a critical aspect of providing safe and effective dental care. It involves a set of practices and protocols designed to prevent the transmission of infections in the dental setting. Here's a comprehensive overview of infection control in dental nursing: 1. Hand Hygiene: Proper handwashing is the foundation of infection control. Dental nurses should wash their hands thoroughly with soap and water or use alcohol-based hand sanitizers before and after each patient contact. 2. Personal Protective Equipment (PPE): Dental nurses must wear appropriate PPE to protect themselves and patients. This includes gloves, masks, protective eyewear, and gowns. PPE should be changed between patients. 3. Sterilization and Disinfection: All dental instruments and equipment that come into contact with patients should be either sterilized or disinfected, depending on their use. Sterilization kills all microorganisms, while disinfection reduces the number of microorganisms to a safe level. 4. Environmental Surface Cleaning: All surfaces in the dental office, including chairs, countertops, and dental units, should be regularly cleaned and disinfected to prevent cross-contamination. 5. Instrument Handling: Dental nurses must handle instruments and sharps with extreme care to avoid accidental needlesticks or injuries. Proper disposal of sharps in designated containers is crucial. 6. Barrier Techniques: Disposable barriers, such as plastic covers or bags, should be used on surfaces that are difficult to clean and disinfect, like light handles and switches. 7. Waste Disposal: Biohazardous waste, including contaminated gloves, masks, and sharps, should be disposed of following specific guidelines and in designated containers. 8. Vaccination: Dental staff should be up-to-date on vaccinations, including hepatitis B, to protect against bloodborne infections. 9. Patient Screening: Screening patients for infectious diseases and inquiring about recent illnesses helps determine the appropriate infection control measures for each case. 10. Pre-procedure Rinse Patients may use an antimicrobial mouthwash before dental procedures to reduce oral bacteria, which can be especially important in certain dental treatments. 11. Post-Procedure Cleanup: After each patient visit, all waste materials should be disposed of properly, and surfaces should be disinfected. 12.Education and Training: Continuous education and training for dental staff are essential to ensure that everyone is aware of the latest infection control protocols and best practices. 13. Records and Documentation:** Detailed records of infection control procedures, sterilization processes, and staff training should be maintained to demonstrate compliance with guidelines and regulations. In dental nursing, strict adherence to these infection control measures is paramount to protect patients and dental staff from the spread of infections and maintain a clean, safe, and hygienic environment in the dental office. PERSONAL PROTECTIVE EQUIPMENTS USED IN DENTAL PRACTICES AND THEIR USE Personal Protective Equipment (PPE) refers to equipment, clothing and accessories to protect medical staff from potential health and safety hazards in working environments. The PPE in a dental practice is almost exclusively used during sterilization processes. It is as follows: a.The cut-proof gloves: must be made from a material capable of withstanding mechanical stress and tearing. In dental practices, it is very common for gloves made of aramid fibres to be used because they are extremely resistant not only to cuts but also to heat and wear and tear. b. The protective face masks for the mouth and nose are used to prevent potentially infected biological or chemical substances from being inhaled. They cover both the mouth and the nose to prevent inhalation through either. c.Waterproof gowns are made from special fabrics that repel water and various kinds of liquids. They can withstand contact with corrosive liquid chemicals. However, the waterproof gowns mostly tend to be used to protect the body from biological liquids. d.To prevent biological or chemical materials from accidentally coming into contact with the delicate structure of the eyes, during the sterilization of dental instruments and materials, protective glasses with mask-style or side protection are used. They protect the eyes by wrapping around the face. The PPE selection in a dental practice also includes all of the equipment needed to protect dentists during a dental appointment: disposable sterile gloves, masks, protective glasses (for when a dental drill is used) and disposable gowns. PPE protects and prevents harm to dentists and medical staff, but appropriate use and regular maintenance (when necessary) also preserves the health and safety of patients by preventing the spread of infectious diseases. IMPORTANCE OF INFECTION CONTROL IN DENTAL NURSING 1.Protect the Health of Patients and Staff 2.Prevent the Spread of Viruses and Diseases 3.Preserve the Reputation of Your Dental Office 4.Follow Dental Office Infection Control Regulations 5.Promote Public Good and Knowledge CASE STUDIES AND CLINICAL SCENARIOS Case study: Mrs. Smith is a 55-year-old woman who presents with a chief complaint of tooth pain. She reports that the pain has been worsening over the past few weeks, and it is now affecting her ability to sleep and eat. She has a history of diabetes and hypertension, and she takes medication for both conditions. Upon examination, the dentist finds several cavities and signs of gum disease. He recommends a treatment plan that includes fillings, periodontal therapy, and fluoride treatments. NURSING DIAGNOSIS 1. Acute pain related to dental caries, as evidenced by the chief complaint of tooth pain and the presence of cavities on examination 2. Impaired Dentition related to deficient knowledge regarding dental health as manifested by presence of tooth caries NURSING CARE PLAN FOR A CLIENT WITH TOOTH PROBLEM. Nursing Diagnosis OBJECTIVES Nursing Intervention SCIENTIFIC RATIONALE EVALUATION Acute pain related to disease condition evidenced by patients verbalization Patient will verbalize less pain within 30 minutes of nursing interventions. 1)Assess pain characteristics (quality, severity, location, onset, duration, precipitating and relieving factors). 2) place patient in a comfortable position. 3) provide a therapeutic environment for the patient. 4)Instruct the patient to assess the effectiveness of the interventions used and report them to the care team. 5) Administer prescribed analgesics. Accurately assessing the patients pain is the first step to planning effective pain management To promote comfort In order to promote adequate rest and sleep. Feedback can assist the care team in modifying and improving pain control strategies. In order to reduce the pain . Patient verbalized reduced pain after 30 minutes of nursing interventions. Impaired dentition related to the impaired oral mucous membrane and skin integrity, imbalanced nutrition, acute pain, as evidenced by dehydration, mouth sores, skin lesions, and decrease in immunity 1.The patient and the family will know how to improve their nutritional intake. 2.The patient and the family will understand how to prevent infection. 1.Educate the patient and carefully plan and carry out a mouth care regimen after each meal regularly. 2. Demonstrate to the patient and family the proper way of washing hands. Also, educate the patient, family, and caregivers on the rationale and suitable procedure for maintaining isolation. 1.This will assist the patient in keeping his or her lips and mucosa moist, intact, clean and soft. 2.This will help the patient and family the importance of preventing the risk and spread of infection. 1.The patient adheres to the mouth care regimen and now obtains moist, intact, soft, and clean lips and mucosa. 2.The patient and his family are doing their part to stop the risk and spread of infection. Legal and Ethical Considerations Nurses in dental and oral health have specific legal responsibilities and documentation requirements. They must: 1.Adhere to Licensing and Certification: Ensure they hold the necessary licenses and certifications to practice as a dental nurse in their jurisdiction. 2.Maintain Patient Confidentiality: Uphold patient confidentiality as per healthcare privacy laws, like HIPAA in the United States. 3.informed Consent: Ensure patients provide informed consent for treatments, surgeries, or procedures, and document this consent. 4.Record Keeping: Maintain accurate and detailed patient records, including medical history, treatment plans, medications administered, and progress notes. 5.Adherence to Protocols and Guidelines: Follow established protocols, guidelines, and standards of care in dental nursing practice. 6.Report and Document Incidents: Report any incidents, accidents, or adverse events promptly and accurately. Document actions taken and any follow-up care provided. 7.Continuing Education: Stay updated with the latest developments in dental and oral health nursing through continuing education and training. 8.Documentation of Education and Training 9.Communication with Other Healthcare Professionals: Maintain effective communication with dentists, dental specialists, and other healthcare team members, and document this communication as necessary. 10.Legal and Ethical Considerations: Abide by legal and ethical principles in patient care, ensuring dignity, respect, and non-discrimination. CONCLUSION In summary, proper oral hygiene is the foundation for a beautiful smile and a healthy life. By following these guidelines, you can ensure a healthy, confident smile and maintain strong teeth and gums throughout your life. Remember, a little effort in oral care goes a long way in promoting overall well-being. Proper oral hygiene is essential for healthy teeth and gums. This includes daily brushing and flossing. In addition, you should see your dentist regularly for dental exams and cleanings. Preventative dentistry gives you the best chance for a beautiful smile and long-lasting oral health.This means you can stop oral health problems — such as cavities, gum disease, bad breath (halitosis) and other issues — before they start by taking good care of your teeth and gums. Download 98.49 Kb. Share with your friends:
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