Impaired dentition refers to a disruption in tooth development, eruption patterns, or structural integrity of individual teeth. This nursing diagnosis focuses on identifying oral health issues, preventing complications, and maintaining optimal dental hygiene.
Causes (Related to)
Impaired dentition can result from various factors affecting oral health:
- Poor oral hygiene practices
- Limited access to dental care
- Nutritional deficiencies
- Medical conditions affecting tooth development
- Systemic conditions such as:
- Diabetes
- Autoimmune disorders
- Cancer treatments
- Eating disorders
- Environmental factors including:
- Trauma
- Grinding/bruxism
- Tobacco use
- Excessive sugar consumption
Signs and Symptoms (As evidenced by)
Impaired dentition presents various indicators that nurses must recognize for proper assessment and intervention.
Subjective: (Patient reports)
- Tooth pain or sensitivity
- Difficulty chewing
- Bad breath
- Bleeding gums
- Changes in bite alignment
- Loose teeth
- Difficulty speaking
- Decreased appetite
Objective: (Nurse assesses)
- Missing or broken teeth
- Tooth decay/cavities
- Dental plaque buildup
- Gum inflammation
- Tooth discoloration
- Malocclusion
- Halitosis
- Poor oral hygiene
Expected Outcomes
The following outcomes indicate successful management of impaired dentition:
- The patient will demonstrate proper oral hygiene techniques
- The patient will maintain adequate nutritional intake
- The patient will report decreased oral pain
- The patient will show improved oral health status
- The patient will develop a consistent dental care routine
- The patient will schedule regular dental checkups
- The patient will identify factors contributing to dental problems
Nursing Assessment
Evaluate Oral Health Status
- Examine teeth and gums
- Note missing or damaged teeth
- Assess oral hygiene practices
- Document the presence of pain
- Check for signs of infection
Review Medical History
- Identify contributing conditions
- Note current medications
- Check allergies
- Review previous dental procedures
- Document family history
Assess Nutritional Status
- Evaluate dietary habits
- Monitor food and fluid intake
- Check weight changes
- Assess the ability to chew/swallow
- Note dietary restrictions
Monitor for Complications
- Check for signs of infection
- Assess pain levels
- Monitor for bleeding
- Note speech changes
- Evaluate swallowing ability
Review Risk Factors
- Assess lifestyle habits
- Document oral care routine
- Note access to dental care
- Check medication effects
- Evaluate knowledge deficits
Nursing Care Plans
Nursing Care Plan 1: Impaired Dentition
Nursing Diagnosis Statement:
Impaired Dentition related to inadequate oral hygiene practices as evidenced by visible plaque buildup and dental caries.
Related Factors:
- Poor oral hygiene
- Limited knowledge of dental care
- Inadequate access to dental services
- Nutritional deficits
Nursing Interventions and Rationales:
- Assess current oral hygiene practices
Rationale: Identifies areas for improvement - Teach proper brushing and flossing techniques
Rationale: Promotes effective plaque removal - Demonstrate the use of oral care equipment
Rationale: Ensures proper technique and compliance
Desired Outcomes:
- The patient will demonstrate proper oral hygiene techniques
- The patient will show improved oral health status
- The patient will maintain a regular dental care routine
Nursing Care Plan 2: Acute Pain
Nursing Diagnosis Statement:
Acute Pain related to dental caries and inflammation as evidenced by verbal reports of tooth pain and difficulty eating.
Related Factors:
- Dental decay
- Gum inflammation
- Exposed nerve endings
- Infection
Nursing Interventions and Rationales:
- Assess pain characteristics
Rationale: Guides appropriate pain management - Administer prescribed pain medication
Rationale: It provides comfort and enables proper nutrition - Apply cold/warm compress as indicated
Rationale: Reduces inflammation and discomfort
Desired Outcomes:
- The patient will report decreased pain levels
- The patient will maintain adequate nutritional intake
- The patient will identify pain management strategies
Nursing Care Plan 3: Risk for Infection
Nursing Diagnosis Statement:
Risk for Infection related to compromised oral integrity as evidenced by dental caries and gum inflammation.
Related Factors:
- Broken tooth surfaces
- Poor oral hygiene
- Compromised immune system
- Inadequate nutrition
Nursing Interventions and Rationales:
- Monitor for signs of infection
Rationale: Enables early intervention - Teach infection prevention measures
Rationale: Reduces risk of complications - Promote proper oral hygiene
Rationale: Maintains oral health
Desired Outcomes:
- The patient will remain free from oral infection
- The patient will demonstrate infection prevention measures
- The patient will maintain adequate oral hygiene
Nursing Care Plan 4: Imbalanced Nutrition
Nursing Diagnosis Statement:
Imbalanced Nutrition: Less than Body Requirements related to difficulty chewing as evidenced by weight loss and decreased food intake.
Related Factors:
- Oral pain
- Difficulty chewing
- Limited food choices
- Altered taste sensation
Nursing Interventions and Rationales:
- Assess nutritional status
Rationale: Identifies nutritional deficits - Modify food consistency as needed
Rationale: Facilitates safe consumption - Monitor weight and intake
Rationale: Ensures adequate nutrition
Desired Outcomes:
- The patient will maintain adequate nutritional intake
- The patient will demonstrate weight stability
- The patient will report an improved ability to eat
Nursing Care Plan 5: Knowledge Deficit
Nursing Diagnosis Statement:
Knowledge Deficit related to lack of information about oral health maintenance as evidenced by poor oral hygiene practices.
Related Factors:
- Limited health literacy
- Cultural beliefs
- Language barriers
- Limited access to education
Nursing Interventions and Rationales:
- Assess current knowledge level
Rationale: Identifies learning needs - Provide oral health education
Rationale: Increases understanding - Demonstrate care techniques
Rationale: Promotes skill development
Desired Outcomes:
- The patient will verbalize understanding of oral health maintenance
- The patient will demonstrate proper oral care techniques
- The patient will identify resources for dental care
References
- Cortellini P, Bissada NF. Mucogingival conditions in the natural dentition: Narrative review, case definitions, and diagnostic considerations. J Periodontol. 2018 Jun;89 Suppl 1:S204-S213. doi: 10.1002/JPER.16-0671. PMID: 29926948.
- Ercoli C, Caton JG. Dental prostheses and tooth-related factors. J Periodontol. 2018 Jun;89 Suppl 1:S223-S236. doi: 10.1002/JPER.16-0569. PMID: 29926939.
- Jepsen S, Caton JG, Albandar JM, Bissada NF, Bouchard P, Cortellini P, Demirel K, de Sanctis M, Ercoli C, Fan J, Geurs NC, Hughes FJ, Jin L, Kantarci A, Lalla E, Madianos PN, Matthews D, McGuire MK, Mills MP, Preshaw PM, Reynolds MA, Sculean A, Susin C, West NX, Yamazaki K. Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol. 2018 Jun;45 Suppl 20:S219-S229. doi: 10.1111/jcpe.12951. PMID: 29926500.
