• Oral hygiene protocols need to be individualized to meet the specific requirements of each patient. This can be done through oral hygiene “rounds”, or consultations with other professionals, e.g. dentistry, nursing, pharmacy, dietary, etc.
• Simple basic oral care is often better than complicated routines. A good soft toothbrush can be used for most purposes.
• Aspiration during oral care needs to be prevented in dysphagia patients who aspirated on thin liquids, i.e. those who require non-oral feeding or thickened fluids. Suction toothbrushes are recommended for this purpose.
• Patients with teeth need Fluoride – products containing Fluroide are therefore preferable for these patients.
• Products containing alcohol are not recommended because of its drying effect.
• Products containing petroleum are not recommended, because they are greasy and flammable and should not be used with oxygen. They do not moisturize and provide a barrier only. Water-soluble products are recommended for hydration.
• Product ingredients should match the pH balance of the mouth (5.0 to 7.0)
• Take into consideration who is doing and receiving the oral care (patient, relatives, staff) and tailor the equipment accordingly. Provide oral hygiene education to that specific person or persons.
• Availability of products can affect their usage for appropriate purposes. Try to eliminate availability of products which are typically used for oral care but contra-indicated. Have preferred products readily available.

Compiled by Trudy Hebbes,
Dental Hygienist,
Toronto Rehabilitation Institute
Queen Elizabeth Centre
130 Dunn Avenue
Toronto, Ont, M6K 2R7