Nil by Mouth and a Healthy Mouth
Simple, pictorial information to improve understanding of the importance of, and how to achieve, oral health (a healthy mouth) when 'nil by mouth'.
For people with learning disabilities and/or acquired cognitive or communication issues.
Based on information originally developed by NHS Lothian Learning Disability Service.
Endorsed by the British Dietetic Association.
Advice requires some explanation from a Health Professional who has basic nutrition knowledge to enable correct implementation.
To improve understanding of the importance of, and how to achieve oral health (a healthy mouth).
Designed for people at risk of poor oral health with learning disabilities, cognitive or related communication difficulties e.g. long-term feeding problems, environmental/social/behavioural/sensory issues, autism spectrum disorders (ASD).
With the Healthy Mouth range (9044, 9045 and 9046), the target group will understand how to maintain a healthy mouth, including when they are using oral nutritional supplements, food thickeners and/or on ‘nil by mouth’:
The target group will know:
- how to brush their teeth, gums and tongue
- to brush their teeth, gums and tongue at least 4 times a day
- if they wear dentures, they must clean these frequently
- to visit their dentist regularly
- drinking through a straw may protect their teeth
- how to maintain their oral health when they take their medication
- what food, drinks and snacks to choose for a healthy mouth.
The target group will understand that taking their medication is vital for their health.
- All Wales Special Interest Group in Special Oral Care. Oral Nutritional Supplementation and Oral Health Recommendations for health care professionals to reduce the impact of Oral Nutritional Supplementation (ONS), sip feeding and nutritional advice on dental health (2009) http://www.sigwales.org/wp-content/uploads/sipfinalcorrectedapril201053.pdf (accessed 18/01/17).
- All Wales Specialist Interest Group Oral Health. Dysphagia and oral health recommendations for the dental team for the management of oral health care of children and adults with dysphagia; April 2014.
- Barr O, Gilligan J, Kane T, Moor G. Health screening for people with learning disabilities by a community nursing learning disability service in Northern Ireland, Journal of Advanced Nursing; 1999, 29, 1482-1491.
- Cicero J. Thickening agents used for dysphagia management; effect on bioavailability of water, medication and feelings of satiety. Nutrition Journal 2013; 12.54, DOI; 10.1186/1475-2891-12-54.
- Emerson E, Baines S. Health Inequalities & People with Learning Disabilities in the UK; Learning Disability Health Observatory. Dept. Health; 2010 https://www.improvinghealthandlives.org.uk/uploads/doc/vid_7479_IHaL2010-3HealthInequality2010.pdf (accessed 18/01/17).
- Longmore SE et al. Predictors of aspiration pneumonia: how important is dysphagia? Dysphagia, 1998 Spring; 13;69-81.
- National Heath Institute for Health and Clinical Excellence. Nutrition support for adults; oral nutrition support, enteral tube feeding and parenteral nutrition. Clinical Guideline CG32; 206.
- National Oral Health Improvement Strategy for Priority Groups; Scottish Government; May 2012. http://www.gov.scot/Resource/0039/00394171.pdf (accessed 18/01/17).
