Today we would like to share some information with you regarding, “an epidemic that is almost universally overlooked,” as stated by Dentist Sarah J. Dirks. The epidemic she is referring to is the poor dental hygiene in nursing homes. The New York Times published an article about this topic on August 4th. The article highlights the story of one woman named Katherine Ford who visits her father at the nursing home in which he resides in Virginia. Her father, Dean Piercy is a World War II veteran and suffers from dementia. She eventually noticed that there was dust on his toothbrush and that his teeth had not been brushed recently so she began doing the task herself after lunches. Unfortunately, the situation became worse. Mr. Piercy began complaining of a severe headache that would not let up. After continually pressing the issue, staff finally made a dental appointment for the patient and it was discovered that a tooth had broken in two and part of it had lodged into the roof of his mouth. Sadly, the article claims, this is just one out of many nursing home patients who receive poor dental care.
The New York Times attributes this lack of dental hygiene to the fact that employees are rarely prepared to provide the proper dental care. They state that residents now require more dental care than was necessary in the past, but aides are already busy with many other important tasks such as helping residents to the toilet or repositioning them in bed. Somehow, brushing their teeth tends to fall to the bottom of their to-do list. Brushing resident’s teeth can also be extremely difficult when a resident has dementia and refuses. Staff are often not trained to cope with this and therefore, the task simply does not get done.
In the past, dental hygiene was less of a concern because a majority of patients had false teeth. Today, Americans are more likely than ever to still have their natural teeth. One study, referenced in the NY Times article, showed a decline in total tooth loss in older people from 1988-2004, therefore it is now time that this matter is addressed properly. The poor dental hygiene found in nursing homes today is especially concerning because recent studies have found that bad dental hygiene is linked to pneumonia. Pneumonia is one of the leading causes of death in older people. The Journal of American Geriatric Studies stated that about one in 10 cases of deaths in nursing homes due to pneumonia could be prevented with the implementation of better dental hygiene. In addition, dental care is also important for those on certain medications which can cause dryness of the mouth.
What can you do to make sure that your loved one is receiving the proper dental care while in nursing home placement? Ask your loved one if staff is cleaning their teeth or dentures on a daily basis. Also ask staff if this task is being done on a daily basis so that they know you are top of the care being provided. In addition, check their toothbrush often to make sure it looks used. If you are visiting in the early morning or before bedtime, make sure the toothbrush is wet which would indicate usage. Your loved one should also be seen by a dentist regularly, even if they have dentures. If you feel that your loved one is not receiving the proper dental care, it is crucial to bring your awareness of this to the staff’s attention. The following three part memorandum, When a Loved One Enters a Nursing Facility contains an advocate’s checklist that can help you monitor for proper hygiene and other long term care needs: Part 1, Part 2, Part 3.