NPO means "nothing by mouth." It means you can't eat, drink, or swallow anything. Your care team may have you use a feeding tube before surgery, during a hospital stay, or because of a health condition. If you have a feeding tube, you may be NPO for weeks or even months at a time.

When you stop eating and drinking by mouth, your body makes less saliva. Saliva is the fluid in your mouth that washes away germs and keeps your mouth clean. Without enough saliva, germs can build up quickly on your teeth, gums, and tongue. These germs can travel into your lungs and cause a serious infection.

Oral care is very important for people when you can't eat or drink in the usual way. Regular mouth care helps prevent infection, reduces the risk of serious illness, improves comfort, and supports a faster recovery.

Aspiration pneumonia is a lung infection that happens when germs from the mouth or throat are breathed in and enter the lungs. Aspiration means breathing something into the lungs that should not be there. People who are NPO or have a feeding tube are at higher risk. This type of pneumonia can cause fever, trouble breathing, or a new cough. It can also make a hospital stay longer or slow recovery at home.

In most cases, the teeth or gums are brushed gently at least 2 times a day using a soft-bristle toothbrush. If you have teeth, a small amount of toothpaste is used. If you do not have teeth, the gums and tongue can be cleaned with a soft, damp foam swab. Some care teams suggest cleaning the mouth every 2 to 4 hours. Your care team can tell you what is right for your situation.

Gently turn your head to the side during cleaning to help prevent fluid from going into the lungs. A small basin or cup can be used to collect any fluid. Washing hands before and after care is also important.

Before using any mouth rinse, check with your care team. Products that contain alcohol are generally avoided because they can dry out the mouth and make things worse. Keeping the lips moist with a water-based lip balm also helps improve comfort.

If a family member or friend helps care for you at home, they can assist with daily mouth care. Before you leave the hospital, your doctor or nurse can show your caregiver how to clean your mouth safely.

Common supplies for mouth care at home may include:

• A soft-bristle toothbrush or foam mouth swabs.
• Toothpaste.
• A mouth rinse (if suggested).
• A water-based lip balm.
• A small basin or cup.

Your doctor or nurse can let you know what you need before you go home.

Let your doctor know if you notice sores, swelling, white patches, or pain in your mouth or if you see or smell something unusual.

Contact your doctor right away if you develop a fever, fast breathing, or a new cough. These can be signs of aspiration pneumonia. Before leaving the hospital, ask your care team what signs to watch for in your situation.