It takes more effort for the elderly and disabled to keep teeth and gums healthy.Dry mouth and decreased saliva flow brought on by age, illness, and some medications can increase decay and gum infections. A general guideline is to have your loved one try to eat a well-balanced, low-sugar diet, and drink lots of water.Recent studies now correlate gum infections to other medical conditions like heart disease and pneumonia.With this finding, good oral health becomes even more important for the elderly and disabled. Guidelines for Elderly or Disabled Caregiver Brushing and flossing after meals and before bed is crucial.For those who find it difficult to handle dental tools, there are a number of ways to adapt:
Enlarge a toothbrush handle by wrapping it with tape or inserting it into a rubber ball or a bicycle grip handle.
Elongate the handle by taping some sort of sticks (a couple of tongue depressors, ice cream sticks, or small plastic or wooden rulers) to it.
Consult with your dentist or hygienist about investing in an electric toothbrush.
Consider a floss holder or aid.
If you are responsible for someone else’s oral hygiene, remember:
Visit a dental professional regularly.It is recommended that an elderly person who relies on others to clean his/her teeth visit a dentist twice as often as normal.That means up to 4 times a year—and some home health aides suggest five or six times a year.As a caregiver, you may potentially miss spots that a professional can more thoroughly address.
Stand behind your loved one to brush.It’s easier to comfortably prop your loved one on the couch while you stand behind him/her and gently tilt his/her head back on some pillows.
Combine a ¼ teaspoon each of salt and baking soda with warm water, swish, and then spit for cleansing between meals or between brushings to decrease acids that cause decay.
Products may be recommended (Act, Gel-kam, Biotene,Xylitol,Listerine and Peridex)
Use gauze or a washcloth to clean someone’s gums (whether or not they wear dentures).Always remove partials and dentures and cleanse them daily.
Protect your hands. If a bite reflex exists, there are soft props that can be gently inserted into the mouth.Ask your dentist or dental hygienist for more information.
Communicate clearly.If a person suffers dementia, visiting the dentist can be upsetting, so a caregiver needs to clearly communicate the purpose of the appointment and schedule it for a time of the day when your loved one might be most alert.
Ask for a house call.If your care recipient requires extra assistance, some dentists or specially trained Hygienists (RDHAP) make house calls.Share any special needs you may have when you make the appointment.(To find an RDHAP in your area visit www.CDHA.org)
Special Access Dental Wendy Williams, BS RDHAP Mobile Dental Hygiene for the Elderly and Disabled www.specialaccessdental.com714-394-0294
Cleaning Teeth Prevents Pneumonia in Nursing Homes
Regular cleanings of teeth and gums may help prevent pneumonia in nursing home residents.
The results are based on comparing pneumonia rates between residents of 11 nursing homes in Japan who received regular teeth cleanings and those who received no additional oral care. The researchers found that residents whose teeth were regularly cleaned had fewer cases of pneumonia and were less likely to die from the infection.
Pneumonia is caused by germs that build up in the lungs and block the flow of oxygen to the body. If the mouth is not clean, there are more germs in the mouth and throat, increasing the chances of sparking an infection. If air and/or material brought into the lungs have lots of germs in it to begin with, it makes it easier for an infection to get started.
However, the oral care administered in this study was quite intense, and perhaps not something to which all nursing home residents would agree. As part of the study, 184 residents were given tooth brushings after every meal and some were swabbed with a bad-tasting antiseptic. In addition, they received professional cleanings once a week from a dentist or dental hygienist.
Some of the 182 residents not assigned to the oral care group brushed their own teeth, and those with dentures had them cleaned regularly, but they did not receive any additional assistance in cleaning their teeth or dentures.
After following the patients for 2 years, the investigators found that residents whose teeth were not given additional dental care were almost twice as likely to get pneumonia. In addition, these residents were twice as likely to die from the infection, relative to those whose teeth were cleaned regularly.
One of the required daily nursing chores in US nursing homes is oral care, but previous studies have shown that this is rarely enforced or done effectively. While ensuring residents receive regular dental care will cost money, the price is significantly less than the costs associated with pneumonia. Although most patients may not like the antiseptic, he said facilities could hire a staff member exclusively charged with brushing residents' teeth.
It is very compelling to have evidence that a common-sense, cheap, anyone-can-do-it intervention -- that is supposed to be done anyway -- could be saving multiple billions of dollars.
The benefits of oral care go beyond simple economics. As important as the cost savings, though, should be the improved odor, taste perception, food enjoyment, and social interaction -- altogether loosely referred to as quality of life -- that occurs when the daily oral care is provided as it should be.
Health officials say 76-year-old woman's dental hygiene was neglected at Petaluma facility
By PAUL PAYNE THE PRESS DEMOCRAT
A Petaluma nursing home was fined $100,000 after state investigators concluded poor health care at the facility led to the death of a 76-year-old patient, officials said Thursday.
Pleasant Care Convalescent of Petaluma is accused of neglecting the dental hygiene of a patient with Alzheimer's disease who developed an infection and died March 12, said Norma Arceo, a spokeswoman for the California Department of Public Health.
The patient, who was not identified, did not receive an examination in her 19 months at the Hayes Lane facility because nursing home officials thought she wore full dentures, Arceo said.
"It's very, very serious," said Anna Ramirez, chief of the department's field operations branch. "This person should not have died."
It was at least the fourth death since 2003 that state investigators have attributed to negligent care at nursing homes owned by Pleasant Care Corp. California's second-largest nursing home chain, according to newspaper reports.
The firm, which is in bankruptcy, was fined $80,000 in June after an investigation found that poor care led to the death in 2005 of a 54-year-old resident in Norwalk, the Los Angeles Times reported.
A patient at Pleasant Care's Ukiah facility died in 2003 after a nurse was unable to provide needed aid because certain equipment wasn't kept in working order, according to the state Justice Department. A year later, a resident at its Novato facility suffered a bed sore that went untreated so long that it ultimately killed the person.
Last year, Pleasant Care agreed to pay more than $1.3 million to settle a lawsuit brought by the Justice Department alleging the chain, which had 30 facilities, provided negligent care to scores of residents.
Other provisions of the settlement included mandatory training, improved nurse-to-patient ratios and protections for whistle-blowers.
Company officials Thursday declined to comment on the Petaluma case, but Dahlia Jimenez, a vice president for finance, said the facility was auctioned earlier this week.
A new owner was not named.
The penalty for the death in Petaluma was the most severe allowed under state law, Arceo said.
It stemmed from the March 4 admission of the patient, at the family's request, to an acute care hospital to treat high fever and neck swelling, Arceo said.
Doctors traced the source of the problem to the patient's mouth, Arceo said.
Decaying teeth and food debris had spread infection, putting the patient at "risk for sudden death," one physician said in an investigative report.
She died from complications in the hospital eight days later, Arceo said.
Although her condition required total assistance with personal hygiene, there was no indication that the nursing home arranged for a dental exam since her admission in August 2005, Arceo said.
An employee told investigators he performed oral care with a green swab sponge, investigation documents said.
Another worker said she saw dentures in a cup and assumed a dentist's visit was unneeded, the documents said.
Oral Health a Matter of Life and Death for Seniors
Source: PR Newswire
Citing a California nursing home death linked to an untreated oral infection, the statewide organization representing dental hygienists today called for greater focus on the oral health of seniors residing in nursing and convalescent homes.
"Oral health is not a cosmetic issue -- it can be a matter of life and death, especially for seniors," said Jean Honny, president of the California Dental Hygienists' Association (CDHA), the professional organization representing the state's dental hygienists.
Honny pointed to recent media coverage of a 76-year-old woman who died earlier this year at a Northern California nursing home that state health officials said neglected the woman's dental hygiene. The patient developed an oral infection that lead directly to her death.
"Such tragedies can be avoided if the advocates, health care professionals and family members better understand the importance of oral health," she said. "September is Healthy Aging Month and a perfect time to promote sound oral health for our elderly population."
CDHA offered the following tips to make sure seniors receive the care they need:
-- Make sure the patient receives a full oral inspection during the intake process
-- Realize that even a senior with dentures needs dental care and check ups. Dentures must fit properly in order to prevent pain and the possibility of infection
-- Nursing home patients should have a minimum of one oral exam per year
-- Family members should investigate how their loved ones can conveniently be transported to a dental office if necessary
"There is a misconception that loss of teeth is inevitable and that dentures take all dental care issues off the table," said Honny. "But this couldn't be further from the truth because dentures can hide serious infections and early signs of cancer."
For the past year, CDHA has been raising public awareness about oral health and the role of dental hygienists, who are highly educated and must be licensed by the State of California. In addition to helping patients understand the connection between oral health care and overall health, dental hygienists educate patients about proper oral hygiene and treat periodontal disease to prevent the condition from advancing and complicating other diseases.
The California Dental Hygienists' Association (CDHA) is the authoritative voice of the state's dental hygiene profession. While registered dental hygienists have worked in the state for nearly a century, CDHA was established 20 years ago when two regional associations merged to form a unified professional group. CDHA represents thousands of dental hygienists throughout the state and is dedicated to expanding opportunities for the profession and access to care for all Californians.
Healthy Aging(R) Month is an annual observance month designed to focus national attention on the positive aspects of growing older. More information can be found at http://www.healthyaging.net.