Geriatric dentistry in nursing homes in California is becoming very popular for good reasons. Incorporating a daily oral hygiene program that is well-structured has a beneficial effect on nursing home residents and the entire healthcare team. However, in some cases, it is not logistically easy to accomplish such a program. In most nursing homes, up to 80 percent of the residents don’t receive good daily oral care even though most of the residents have difficulty brushing their teeth due to physical and cognitive limitations. Generally, oral health care isn’t considered in most personal hygiene protocols for seniors in long-term care facilities.
The work of brushing teeth twice a day for each resident takes a lot of time. Additionally, providing consistent oral care and hygiene for the residents with dementia in the long term care nursing homes poses special challenges. The reduced cognition of the residents and increased resistance can affect oral care provided by the staff. Sometimes, the resistance behavior can escalate to a point where the staff are injured. Residents with dementia may bite or strike the staff. In case of such challenges, it is important to educate the staff on the techniques and rationale of good oral hygiene to help them understand both the benefits and the process for the residents.
Oral health assessment
Oral health assessment should be timed routinely and systematically. During the comprehensive medical evaluations, the residents should undergo a full oral assessment and examination. Geriatric dentistry in nursing homes in CA should involve examining all the nutritional changes, prostheses, swallowing issues and mastication, mucosal disease, pain, periodontal issues, dental caries and salivation. The residents should be examined without or with prostheses in place to look for mucosal lesions, fit and ease of prosthetic insertion and removal.
The next step is to assess the systemic factors and this incorporates medical problems, communication with previous doctors and medications. Part of the overall team evaluation tests the function and mental capacity of the residents with communication attention and their level of skills in doing oral self-care practices as assessed by both a physician and occupational therapist. The initial comprehensive evaluation is then followed by an admission evaluation by a dental professional. If the resident develops any symptoms in the interim period, in-house treatment ensure with referral to a dentist as needed.
Brushing challenges
By coming up with an organized system-wide approach to oral health care, a facility may overcome the challenges of regular teeth brushing. The main aim of such an approach is to increase the participation of the residents in oral care and enhance oral hygiene involvement. Older residents may have problems with oral self-care for several reasons. Tooth brushing can become complicated in patients with cognitive deficits.
Management goals
Geriatric dentistry in nursing homes in California involves oral management to ensure that the residents receive quality oral care. For residents who have progressive dementia, treatment can be challenging and more problems may arise based on the caregiver’s role in performing daily oral care, overcoming challenges and enhancing communication.
