The sub-standard oral care provided to vulnerable patients in long-term care facilities can have a number of serious consequences. Some of these include increased risk of heart disease, pneumonia, and stroke. There are steps that can be taken to reduce these issues; however, facility management and nurses have to first recognize there is a problem.
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This epidemic of poor oral hygiene in these facilities is seen all over the U.S. With seniors keeping their teeth longer than ever before, they require more dental care; however, the workers at nursing homes may not be prepared to offer that care. Also, there are many residents who decline this care from the staff.
When thinking about challenges facing long-term care residents, the first thing that comes to mind is usually not poor oral hygiene. However, evidence has now linked poor oral health to a number of serious systemic illnesses. Even though many residents need assistance in taking care of their oral care needs, many residents do not get much, if any, oral hygiene care assistance.
While there are no current assessments of oral health care in nursing home facilities, since 2011 there have been at least seven different states that have evaluated their residents based upon oral care. One of these states was Kansas, where there were 540 older residents evaluated by dental hygienists in 20 different facilities. The results showed that about 30 percent of the residents had significant oral debris affecting about two-thirds of their teeth. Also, more than a third of the residents had untreated issues of decay.
While those who screened the patients saw plenty of crowns and fillings, it was concluded that these individuals had not received regular dental care for quite some time.
The issue of poor oral health for nursing home residents is actually multifactorial. One of the biggest ways to ensure good oral health is to ensure daily oral care; however, this seemingly easy task can post a real challenge in a number of long-term care (LTC) facilities. There are a number of residents in LTCs that have a hard time brushing their own teeth because of cognitive impairment, vision problems, limited mobility, or manual dexterity issues. In fact, a study performed by Frenkel and colleagues discovered that between 72 and 94 percent of residents in LTCs have preventive issues when trying to take care of their own oral health needs. In a number of cases, these individuals also did not receive any assistance for caring for their teeth or dentures. Read more about the consequences of poor dental hygiene for the elderly here.
Only about five percent of residents in LTC facilities received help when they needed it. Also, when help was given, the average time spent on the senior's teeth was only 16.2 seconds, rather than the recommended two minutes.
There is more and more evidence emerging that shows the relationship between systemic illness and poor oral health for residents in LTC environments. For a number of years, oral health was considered independent to overall health. However, with contemporary healthcare culture, views are changing to reflect this growing concern. Making changes in long-term health care facilities is essential. This will ensure the long-term health of residents and prevent any unnecessary pain or discomfort.
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