Oral health protocol for the dependent institutionalized elderly.

Establishing an oral hygiene protocol for the frail and functionally dependent elderly should be of special concern to health care providers. The previous assessment of a care center, including patients or residents and staff, allows an effective strategy to be designed. Oral health protocols are mainly based on the daily removal of bacterial plaque from teeth or prostheses (or both), cleaning of oral mucosa, and continual oral hydration. These practices are facilitated by the use of electric toothbrushes and products such as chlorhexidine, fluoride toothpastes, and rinses or gels for dry mouth. This type of protocol should include regular collaboration with dental professionals and provide a program of continuous training for nursing staff on oral health issues.