Long Term Dental Care for Long Term Care Residents
In many ways, the long-term care environment is a perfect one. Seniors with compromised cognitive or physical abilities have a setting that is safe, populated with caring staff, meals and the companionship of like-minded residents. While we would like to believe that the long-term care facility has everything necessary for a happy, serene and protected life, the area most often overlooked is that of routine oral care.
For the most part, this is a correct analysis. The only problem is that it assumes a great deal. To begin, it suggests a staff composed of caring, conscientious caregivers. While that is most often the case, time for patient care can often be minimized in deference to serving the entire population. It also includes good food, safe conditions and a medical component that is capable of treating both acute and chronic resident conditions.
Students of the long-term care environment are quick to remind us of all of the exceptions to this model, a situation that is much less common than consistent, responsible care. For the resident who seeks reassurance that his or her health is a priority, the best indication of that practice begins with oral care.
Many recent studies have shown that the area of oral hygiene and dental care is one that is often overlooked, to the serious disadvantage of long-term care facility residents. Whether it is in the area of dental pain, tooth loss, persistent bad breath, dry mouth, bacterial infection or denture discomfort, very often the resident is in a compromised position with limited options for help.
The mouth is an excellent representation of other conditions from which a resident may be suffering. Presence of systemic diseases can be reflected in the mouth. Bacterial or fungal infections are also detected in the mouth as well as nutritional deficiencies. Unfortunately, the failure to detect these symptoms can result in the incidence of more serious diseases such as cardiovascular disease, diabetes, malnutrition, stroke and pneumonia.
The connection is simple to understand. Bacterial infections that present in the mouth can lead to more serious systemic consequences. With the failure to diagnose and treat these infections while they are part of oral health comes the predisposition to diseases that impact the entire body.
Whose responsibility is the maintenance of routine dental care? Some patients are competent and capable of completing the standard brushing, flossing and rinsing that are inherent to a comprehensive oral hygiene program. This level of competency requires minimal supervision.
Often times the typical long-term care facility population is not thoroughly trained in every aspect of health and oral care, however. Residents are generally in such facilities because of their inability to function independently and there is a good chance that they are incapable of remembering or executing standard daily processes.
In many cases, the incapacity is based on mobility or manual abilities. For patients with Parkinson’s disease, arthritis or stroke can experience pain or difficulty with basic dental hygiene and will avoid, postpone or simply forget to observe daily routines.
Those with cognitive impairment have greater challenges. In addition to experiencing such conditions as dry mouth, gum disease or poorly fitting dentures, they simply cannot be expected to maintain the type of life styles that their contemporaries with full mental capacity enjoy.
Increased attention to patient oral care is the fundamental priority for ensuring patient oral health. The supervision or assistance with brushing can be instrumental in creating good habits, whether done daily or on an as-needed basis. In addition, the dental community has taken great strides in assisting this unique and deserving population by creating the concept of mobile dental care.
Lack of mobility is an ongoing issue for those older citizens living in the residential care facility. Previously, they needed to rely on family members, bus transportation or some form of service to transport them to and from the dentist. This condition exacerbated the dental visit experience by increasing anxiety associated with getting to and from the visit.
Mobile house call dental and denture care has immeasurable value to this situation. This type of care is accomplished through a simple consultation followed by as many visits to the resident as necessary to correct existing conditions and establish an oral hygiene routine.
Once this program is in place, all of the participants in the long-term care setting will benefit. The caregivers will have tools needed for maintenance and identification of conditions worthy of further care. Dental professionals have access to deserving patients within the familiar residential care setting. And the patients benefit by having ongoing intervention and attention to their critically important oral health.
The advantages are obvious and the alternatives have failed to produce the outcomes of residential, mobile dental/denture care. Our senior residents are entitled to the preventive care that is critical to their survival and the dental professional community has created an extremely viable solution.
By Daniel Subbotin BSc, BA, DD
EPICITI Mobile Dental Care offers mobile denture clinic and mobile dental cleaning services for seniors in nursing homes, retirement homes, hospitals, and private residences. If you or your loved-one is looking for a mobile denturist or in-home mobile dental hygienist in Toronto or surrounding area please get in touch with EPICITI. If you are experiencing poor-fitting dentures that cause pain and discomfort or if you have sensitive teeth and sore gums, get in touch with a local housecall denturist or in-home dental hygienist. EPICITI is located at 561 Edward Ave. in Richmond Hill and provides mobile dental services in Toronto, Scarborough, Etobicoke, Mississauga, Oakville, Burlington, Hamilton, Brampton, Vaughan, Markham, Aurora, and Newmarket. Denture housecall services and mobile dental cleaning services are covered by private insurance, Veteran Affairs Canada (VAC), Non-Insured Health Benefits for First Nations and Inuit (NIHB), Ontario Disability Support Program (ODSP), and Ontario Works (OW). www.epiciti.ca or www.MobileDentalClinic.ca