Care givers in long term care settings struggle with providing good oral care for their residents. Consistent, adequate, oral hygiene can be a challenge with long term care admissions that have diagnoses such as dementia and often resist routine dental hygiene. Giving oral care to those who may have a bite reflex is tricky, at best. Some residents are admitted with a history of poor dental care and oral hygiene which makes dental care even more important, but also complicates the provision of these much needed services. And as always, reimbursement for dental care is an issue.
That being said, good oral hygiene can and should be provided routinely. It is an important factor in maintaining overall health and quality of life for the resident. Poor mouth care can result in decreased appetite and poor nutritional intake, as it often diminishes the ability to fully taste and enjoy food. It can contribute to acquired pneumonia from bacteria remaining in the mouth that is released by saliva and then aspirated into the lungs. It is estimated that at least one half of all acquired pneumonias in nursing home residents can be attributed directly to poor oral care. Unmanaged pain can also be a concern for this population resulting from gum disease such as gingivitis, broken/damaged teeth, and open sores in the oral cavity. Many prescription drugs can also have an effect on oral hygiene as they may reduce saliva production and dry out the mouth.
So the question becomes, how do we adequately address oral care in the LTC setting and with the diverse resident population we serve? Begin by setting expected standards of care, and ensure that there are appropriate tools to promote and provide oral care, especially for our more agitated dementia residents. There are new devices and tools coming to the market every day to enhance oral care. Investigate what works best for your team and devise a plan!