Patients with dentures should be encouraged or assisted to remove and clean the dentures daily (Bartlett et al. [16]). The dentures should be cleaned over a towel or a water‐filled sink to reduce the risk of damage if they are dropped. They should be brushed with a toothbrush and a specialized non‐abrasive denture paste or cleaner. Toothpaste should never be used as it is too abrasive for dentures (HEE [82]). The dentures should be rinsed with water before being replaced in the mouth.

Denture wearers should be advised not to keep their dentures in the mouth overnight, unless there are specific reasons for keeping them in. This is particularly important for people at a higher risk of developing stomatitis. Denture wearers are at risk of fungal infections developing under the denture and spreading to the hard palate. Soaking the dentures in a denture cleanser solution after mechanical cleaning is beneficial in assisting the breakdown of plaque, preventing denture stomatitis and reducing the risk of pneumonia (Bartlett et al. [16]).

If it is suspected that a denture‐wearing patient has an oral infection, the dentures should be soaked in 0.2% chlorhexidine for 15 minutes and rinsed thoroughly (HEE [82], Voegeli [237]). Denture wearers should also clean any remaining teeth and their gums and tongue with a soft toothbrush and fluoride toothpaste. Finally, they should have regular dental check‐ups as ill‐fitting dentures can cause ulcers and irritation (Bartlett et al. [16], Burns [29]).

Losing dentures while in hospital can be very distressing to the individual and can have serious effects on their nutrition, ability to communicate, self‐image and overall wellbeing. Furthermore, the financial implications for reimbursement for denture loss are relatively significant for the NHS (Mann and Doshi, [116]). Any denture storage container should be clearly marked with the wearer's personal identification details (HEE [82]). An incident report form must be completed by the clinical unit for every lost denture (HEE [82]).

Unconscious patients require particular interventions to maintain oral hygiene and comfort. For patients who are at the end of life, there is a lack of evidence relating to oral care and the focus should be on patient comfort. Any interventions that cause distress should be reviewed, and the frequency with which mouth care is offered should be dependent on the needs of the individual (AACCN [1], Brooker et al. [26], Riley [199]). Gentle cleaning with a soft toothbrush is recommended and a lubricant should be applied to the lips (Brooker et al. [26]).

In critically ill patients who are unconscious and require mechanical ventilation, oral care management is different (Box 9.9). It is well documented that aspiration of oropharyngeal flora can cause bacterial pneumonia (Brooker et al. [26]). Ventilator‐associated pneumonia (VAP) is a serious complication that can occur in up to a quarter of ventilated patients and has an overall mortality of 13% (Melsen et al. [127]). In critically ill patients, the mouth can become colonized within 48 hours of admission to hospital with bacteria that tend to be more virulent than those normally found in the mouth (Hua et al. [89]). The oropharynx can become colonized, as can an artificial airway, allowing pathogens to travel to the respiratory tract, resulting in pneumonia (Brooker et al. [26]). Good oral care is essential in critically ill patients to reduce the incidence of VAP (Hua et al. [89]).

Dry mouth related to mouth breathing, the patient being nil by mouth and the use of oxygen can make oral care challenging. The presence of tubes and/or securing tapes can make it difficult to view and clean the oral cavity.