7.2 Oral Care, Grooming & Dressing

Oral Care

Oral care (oral hygiene) keeps the mouth clean and moist and prevents pain, gum disease, bad breath, poor appetite, and aspiration pneumonia. Provide oral care at least in the morning and at bedtime, and more often for residents who are NPO (nothing by mouth), receiving oxygen, mouth-breathing, or unable to clean their own mouth.

What the CNA Reports

• Bleeding or swollen gums
• White patches or sores in the mouth
• Loose, broken, or missing teeth
• Cracked lips or dry mouth
• Pain with chewing or refusal to eat
• Cracked or damaged dentures

Unconscious Mouth Care

An unconscious resident still needs oral care, and it carries an aspiration risk. Use safe technique:

• Turn the resident to a side-lying position so fluid drains out, not down the airway.
• Use only a small amount of fluid and oral swabs, not a flooded toothbrush.
• Never put your fingers between the teeth and do not assume the resident cannot hear; explain each step.
• Keep suction nearby if it is part of the care plan, and report any choking, coughing, or color change.

Denture Care

Dentures are expensive and break easily. Handle them carefully and protect the resident's dignity.

• Line the sink with a towel and add water before brushing, so dentures do not break if dropped.
• Brush all surfaces with a denture brush and cool water; hot water can warp dentures.
• Rinse thoroughly before returning them to the mouth.
• Store dentures in a clean, labeled container filled with cool water or denture solution to keep them from drying and warping.
• Never wrap dentures in a tissue or napkin; they are easily thrown away by mistake.
• Report cracked, chipped, or ill-fitting dentures to the nurse.

Grooming

Grooming includes hair care, shaving, nail care, and makeup. It supports self-image and dignity, so honor the resident's preferences and cultural practices.

• Comb or brush hair daily and style it the way the resident prefers.
• Use an electric razor for residents on anticoagulants (blood thinners) or with bleeding risk to avoid nicks.
• For nail and foot care, do not cut the nails of a resident with diabetes or poor circulation; report long or thick nails to the nurse, who follows facility policy.
• Provide care that lets the resident do as much as they safely can.

Dressing and Undressing

Dressing supports dignity and independence. Lay out clothing the resident chooses, provide privacy, and let the resident help where possible.

The Affected-Side Rule

When a resident has a weak, paralyzed, injured, or post-stroke side (often called the affected or weak side):

Dressing the weak arm or leg first avoids forcing a stiff or painful joint through a sleeve and reduces strain on the joint. With an intravenous line or other device, follow the care plan and move the device safely without disconnecting it.

Dignity in Dressing

• Keep the resident covered while changing clothes.
• Offer choices and respect cultural or personal clothing preferences.
• Encourage the resident to fasten buttons or pull up garments as able.

Exam Tip

For Florida written items: with a weak side, dress the affected side first and undress it last. Use an electric razor for blood thinners, line the sink for denture care, and position an unconscious resident side-lying for mouth care.