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IMPAIRED DENTITION Nursing Care Plan

Impaired dentition is a state in which a person experiences a disruption in the integrity of his/her teeth. Our teeth serves a major role in the process of digestion. We use our teeth for biting, cutting, and chewing of food which is the start of the process of digestion so we need to take care of them. Here is a sample of nursing care plan for patients with impaired dentition.

ASSESSMENT
Subjective:
"My tooth is aching, "as verbalized by the patient.

Objectives:
I smell fowl odor from the patient's mouth as he/she is talking to me. This fowl smell of his/her breath is called halitosis. I also noticed that he/she has a tooth enamel discoloration and erosion. There are excessive plaque all over her/his teeth as well as dental carries. By observing him/her, I assume that he/she had a toothache because the patient is guarding his/her left, lower quadrant of his/her face. I've used pain scale to the patient and graded it 7/10.

Vital signs was taken and noted as follows: Body temperature is 35.5 degrees Celcius, blood pressure is 120/80 mmHg, respiratory rate is 17 cycles per minute, and pulse rate is 120 beats per minute. Body temperature, respiratory rate, and pulse rate are normal while his/her blood pressure is above normal and categorize as pre-hypertention.

DIAGNOSIS
Impaired dentition related to toothache as evidenced by tooth enamel discoloration and excessive plaque. (Toothache if a pain or soreness perceive by the person located within or around his/her tooth. Enamel is a hard substance that create a thin layer which covers the tooth).

PLANNING
After 4 hours of nursing intervention the patient's toothache will be diminished. (You can also add to your planning, "also his/her tooth enamel discoloration and excessive plaque will be treated."

INTERVENTION
The first you need to do is to evaluate the patient's current status of dental hygiene and oral health to determine the possible intervention and treatment needs. Note the absence of teeth and dentures and ascertain its significance in terms of nutritional needs and aesthetics. Document presence of factors affecting dentition such as chronic user of tobacco, coffee or tea because these drinks are tooth-stainer causes enamel damage. Bulimia and vomiting causes stomach acid goes to the mouth which destroys the tooth enamel.

Document or get a photo before treatment to provide pictorial baseline for future comparison or evaluation. Encourage the client to use soft toothbrush and use tap water, saline or diluted alcohol-free mouthwashers. If needed, administer antibiotics to treat oral or gum infection and analgesics of topical analgesics for
dental pain. In addition, encourage the patient to limit sugary foods and midnight snacks because as food left on teeth at night is more likely to cause cavities. Note: If the client is baby, regarding age-appropriate concerns, refrain from letting the baby fall asleep with milk or juice in bottle instead use water or pacifier during night. Avoid sharing the eating utensils among family members and don't forget to teach children to brush teeth while young.

For further management of the teeth, refer the client to appropriate care providers such as dental hygienists, dentists, periodontists or oral surgeon.

EVALUATION
After 4 hours of nursing intervention, the patient's toothache has been diminished. (If you add the tooth enamel discoloration and excessive plaque in your planning, just add to your evaluation, "and his/her tooth enamel discoloration and excessive plaque were treated)."

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