Prince Dental Suggested Protocols

Suggested Assessment Protocol:

- Primary nurse assesses residents who are dependent upon nursing personnel and

ones who cannot handle oral secretions.

- Primary nurse prescribes the use of the Plak-Vac suction toothbrush and

specific cleaning agent for that resident.

- Primary nurse assesses if resident’s medical condition requires prior

antibiotic therapy due to advanced poor oral health conditions

- Primary nurse re-assesses resident’s oral health condition weekly to

supervise and ensure compliance.

- Trach and Vent patients needing closer supervision need at least q6 protocols in place

Suggested Personnel Protocol:

- Any nursing staff that has been instructed on suctioning, feels comfortable with

the procedure, and has successfully demonstrated his/her capabilities to a licensed

nurse may use the Plak-Vac Suction Toothbrush as prescribed.

- In more acute care situations, where the nurse assistant is not allowed to perform

any suction in the oral cavity; the nurse assistant performs all prep work, RN

brushes the resident’s teeth with the Plak-Vac, then the nurse assistant cleans

items after use for storage.

- Each time oral care is performed, personnel logs and initials compliance chart

per resident.

Suggested Oral Care Protocol:

- Assemble items needed:

  1. Plak-Vac Suction Toothbrush
  2. Holder & Clip
  3. Suction Pump, Canister & Hose
  4. Oral Care Swab Kit
  5. Alcohol Free Mouthwash or Xylitol Liquid (The Answer)
  6. Cup of Water
  7. Gloves
  8. Bib or Towel
  9. 2 X 2 Gauze & 4 X 4 if mucosa is fragile
  10. Tongue Blades

Suggested Oral Care Protocol (con’t):

- Position Patient & Inform (if possible)

- Set-up Suction Equipment & Plak-Vac

- Swab Thick Secretions & Food Particles (4X4 gauze around Plak-Vac for fragile mucosa)

- Bite Block if necessary

- Dip Plak-Vac into mouthwash or anti-plaque solution with thumb port open

- Brush Teeth & Gums with thumb port closed

- Bend Bristles to evacuate pooled secretions

- Brush Cheeks, Palate, & Tongue, use 2X2 to hold tongue (Unless mucosa is fragile, see above)

- Dip Brush into Cup of Water to clean bristles, bending again

- Apply Moisturizer to mouth & lips

- Flush Plak-Vac with water or hydrogen peroxide

- Air-Dry in Holder per CDC recommendations

- Clean Suction Tubing & Canister with vinegar & distilled water or preferred liquid

- Repeat steps with Swabs and Mouthwash/Anti-plaque & Moisturizer every 2-4 hrs as required

Suggested Replacement Protocol:

- Plak-Vac Suction Toothbrush = Replace Quarterly*

- Suction tubing = Replace Weekly*

- Suction canister = Replace Quarterly*

*Depending on patient’s condition and facility’s infection control protocols.