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Mouth Care for Trach Patients

Having a tracheotomy, an artificial hole in the trachea used for breathing, involves special considerations when it comes to oral hygiene. Normally the air that we breathe is filtered and moistened in the mouth and nose so bacteria and other particulate matter are not introduced into the body. Having a stoma in the trachea eliminates this process, which dries out the mouth, increases odors and decreases the efficiency of the taste buds, making frequent and thorough oral hygiene crucial in maintaining a high quality of life in patients with a tracheotomy.

  1. What You Need and Why

    • When you or someone you are caring for has a trach, there are numerous oral hygiene items that need to be on hand. These include toothbrush and paste, mouthwash, mouth swabs, lip moisturizers and an emesis basin for spitting into if the trach patient cannot utilize the sink. It is important to brush the teeth three times per day, using mouthwash to kill oral bacteria before and after each brushing. Be sure to pay special attention to the tongue to stimulate the taste buds. Between brushings, mouth swabs can be soaked in mouthwash and swabbed throughout the mouth to remove any mucous that has built up and to moisten the mouth. Mouth swabs can also be purchased in flavors, such as lemon. The application of lip moisturizers is crucial in the prevention of dry cracked lips that are common in people with tracheotomies.

    Infection Control

    • Having an artificial hole in the body increases the chance of acquiring an infection. The best way to prevent infection is to keep your equipment clean. Hospitals and nursing facilities have sterile equipment, but this is unlikely to be the case in the home. At home, you can keep your equipment clean by washing basins with warm, soapy water and making sure to wash your hands before and after oral care. Change toothbrushes frequently, and never re-use mouth swabs. Do not share lip moisturizers with others.

    Special Considerations

    • Tracheotomies typically cause the patient to experience a build-up of phlegm in the mouth requiring the use of a suction machine. Be sure to perform oral hygiene immediately following the use of a suction machine after the patient has regained her breath to return moisture to the mouth and rid the mouth of the bad taste of the phlegm. Sometimes people with tracheotomies also have feeding tubes, in which case oral care should be performed every one to two hours.

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