Registered Nurses' Association of Ontario

Referring Clients

  • The nurse, during the initial assessment and during regular oral care, will continually observe for changes in the oral cavity that would necessitate a referral to an oral health professional.
  • It is important to recognize that a team approach including a dentist, dental hygienist, dental assistant and other trained staff will help in the provision of care to individuals with disabling physical, mental, sensory and cognitive abilities.
  • Nurses should also note that tobacco users are at an increased risk of developing oral cancer and lesions, and should consult with a dentist or dental hygienist regularly.
  • Long time use of methamphetamine (MA) has been associated with severe MA induced caries.
  • Indicators for a referral:
    • Aggressive behaviour out of character with the individual
    • Bad breath
    • Bleeding during brushing or during oral care
    • Broken or loose fillings
    • Calculus deposits
    • Chipped or worn teeth or cracked dentures or partials
    • Discolouring of the teeth or tongue
    • Excessive dry mouth
    • Excessive tooth grinding
    • Jaw pain
    • Loose or ill fitting dentures
    • Loose teeth
    • Pain on brushing or stated tooth pain
    • Refusal of dental care
    • Sensitivity to hot or cold
    • Sores or lesions in the oral cavity
    • Swollen gums
    • Visible decay
Clinical Management
Oral Health: Nursing Assessment and Intervention
Point of Care Resources