Tongue coated, dry, other:_____ – Saliva ropey or absent, other:____ – Teeth cracked, cavity – Dentures cracked, warped, poor fit, not – labelled, Debris in the oral cavity plaque, food – Gums and mucous membranes – inflamed, bleeding Bad breath Oral pain Resident requires dentures, are they in place (Yes or No) Unhealthy: Lips ______% Tongue ______% Saliva ______% Problems with ______% Problems with dentures ______% Debris in oral cavity ______% Gums and mucous membranes ______% Bad breath ______% Oral pain: ______% Dentures in mouth: ______% Admission Process (√ for all that apply) audit all new admission in the last quarter or a portion of new admissions Date completed:_____ – Condition Resident Resident Resident Resident Resident Resident Total room # room # room # room # room # room # Oral health assessment completed Oral health dental history completed
Tongue – coated, dry, other:_____ Saliva – ropey or absent, other:____ Teeth – cracked, cavity Dentures – cracked, warped, poor fit, not labelled, Debris in the oral cavity – plaque, food Gums and mucous membranes – inflamed, bleeding Bad breath Oral pain Resident requires dentures, are they in place (Yes or No) Unhealthy: Lips ______% Tongue ______% Saliva ______% Problems with ______% Problems with dentures ______% Debris in oral cavity ______% Gums and mucous membranes ______% Bad breath ______% Oral pain: ______% Dentures in mouth: ______% Admission Process (√ for all that apply) – audit all new admission in the last quarter or a portion of new admissions Date completed:_____ Condition Resident room # Resident room # Resident room # Resident room # Resident room # Resident room # Total Oral health assessment completed Oral health dental history completed
Oral%20Care%20Auditing%20tool%20v5.docx