Nursing home dental care: problems and suggested solutions.

Nursing Home Dental Care: Problems and Suggested Solutions

The goal of long-term care, whether provided in the home or in a nursing home facility, should be to restore and maintain the individual at optimum functioning levels. Unfortunately, in the long list of physical psychological needs, the mouth is considered only one small part of needed care and therefore often ignored. Nursing home personnel, from administration through the direct care staff, must realize that patients who cannot function with dentures, loose and/or decayed teeth are oral invalids whose quality of life suffers badly.

The problems

Self-image often is altered by the time an individual is admitted to a nursing home. Fitting the accumulated belongings of an entire lifetime into one small room can be traumatic. In addition, the circumstances under which people enter a nursing home may make them feel their appearance is no longer deemed important. Consequently, oral hygiene practice may become non-existent.

The poor oral hygiene status of residents of nursing homes has been well documented. Surveys conducted by dental professionals have shown high rates of food debris, tartar, gum inflammations, gum infections and dental cavities. Reports of dirty dentures, bad breath, denture irritation and nutrition problems resulting from poor oral hygiene practices are numerous. It is the responsibility of the nursing home staff to select applicable dental preventive measures based on the latest information. Skill and patience will be needed to teach oral hygiene procedures and to persuade patients to take an interest in their personal oral health. Ultimately, the staff determines the quality and frequency of oral hygiene services provided.

All nursing home facilities have policies and standard operating procedures concerning the oral care of their residents. Some of these policies are quite good. Each resident is given a physical assessment by nursing service upon admission, and a written plan of care is developed accordingly. The plans of all services are integrated to address the patient's total needs - including dental needs.

Although many facilities have complete written policies, the facilities seldom comply with their own written requirements. Admission records have been found woefully inadequate. They contain …