Parkland Dental Hygiene – Ventilator Acquired Pneumonia

hi we’re the Parkland College dental
hygiene students and we will be doing a presentation on ventilator acquired
pneumonia and the importance of proper oral hygiene and intubated patients
today our objectives for this lesson are to explain the connection between the
oral cavity and ventilator acquired pneumonia
we will also be demonstrating proper oral hygiene of intubated patients with
brushing and interdental AIDS we will also be listing auxilary aids
that you could use on intubated patients here are some of the common dental
bacteria that can be found in the mouth of an intubated patient these bacteria
are predominantly gram-negative there are over 500 species associated in
dental biofilm they easily make their way down the respiratory tract
aspiration pneumonia occurs with the micro aspiration of the oral pharyngeal
secretions aspiration pneumonia is most common in the right lobe of the lung
because the stem of the bronchi is directed more vertically than the left
easy transport of bacteria happens this way the biofilm is thicker and more
complex and intubated patients which allows for a heightened risk of
respiratory pathogens to occur in poor oral hygiene of intubated patients the
ET tube is foreign and becomes a great housing for pathogens that can be
inserted into the trachea during the insertion of the ET tube after insertion
the surface of the ET tube has a lot of bacteria that can be inhaled during
normal respirations ventilator acquired pneumonia can also occur from
contaminated respiratory equipment and this pneumonia is often resistant to
antibiotics so first we will be discussing removing plaque with the
modified bass method first you’re going to place the toothbrush at a 45-degree
angle against the gums move the brush back and forth gently in short circular
strokes first you’ll brush the outer surface
all of the teeth and then move to the inner surface and then you will use the
top part of the toothbrush to clean the inside surface of the top and bottom
front teeth use gentle up and down motions finally brush the tongue to
remove bacteria and biofilm place the toothbrush at a 45 degree angle against
the gums move the brush back and forth in small circular strokes brush the
outer tooth surface the inner tooth surface in the chewing surface use the top part of the brush to clean
the inside surface of the top and bottom front teeth use gentle up and down
motions and be sure to brush the tongue to remove bacteria and biofilm next
we’re going to be talking about inner dental care when using a floss handle
you want to break off a piece of floss about an arm’s length wrap the end of
the floss around the circular knob on the back of the handle bring the floss
up and through the indentation on one side and through the indentation on the
other side bring the floss back down and around the circular knob on the back of
the floss handle make sure the floss is threaded reasonably tight glide the
floss between the contacts of the teeth using a gentle back-and-forth motion to
avoid injury never snap the floss into the gum tissue once the floss has
reached the gum line you want to move the handle in a c-shape as to reach all
surfaces of the tooth hold floss tightly against the tooth surface and gently rub
the side of the tooth moving floss away from the gum with an up-and-down motion
while staying in between the same contact move to the adjacent tooth and
repeat continue to do this until all contacts have been cleaned when removing
the plaque from the tube itself take a wet gauze square and gently wipe the
tube as to remove all visible plaque doing this removes the harmful bacteria
that can cause pneumonia this should be done at least twice a day to assure that
there is no accumulation of plaque and bacteria as long as there are no
contraindications you may also use Listerine to wet your gauze square it is
best to clean a patient’s teeth gingiva and tongue two to three times daily with
the soft toothbrush there are many auxilary procedures that can be done for
intubated patients besides brushing and flossing to eliminate oral plaque mouth
rinses can be used in addition to help keep a clean oral environment you can
use either a warm or cold saltwater rinse an alcohol-free
chlorhexidine solution for patients at risk for bacterial infections although
this should be used no more than twice per day
fluoride mouth rinse can also be therapeutic and help to prevent dental
decay and sensitivity in teeth due to possible trauma from the intubation tube
all moistures should be suctioned from the patient’s mouth to remove residual
secretions intubated patients can suffer from dry mouth which can cause an excess
buildup of plaque so it is extremely important after performing oral hygiene
routines to coat the patient’s mouth with a water-based lubricant and apply
to the lips as well to prevent uncomfortable sores we would like to
thank you for taking the time to listen to our video interprofessional
collaboration helps provide the best care possible to patients we are
striving to increase the oral care of intubated patients and appreciate your
help in these efforts

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