Providing Dental Care for Older Adults in Long Term Care

Transcription

1 Providing Dental are for Older Adults in ong erm are Ann Slaughter, DDS, MPH Assistant Professor ourse Director, Geriatric Dentistry University of Pennsylvania School of Dental Medicine Delaware Valley Geriatrics Education enter EARNING OBJEIVES Direct are Staff will be able to: 1. Discuss why good dental health promotes overall health and quality of life 2. Describe the potential benefits to nursing care delivery when daily dental care is maintained 3. Discuss plaque bacteria and how prevention can protect the mouth from damage caused by plaque Delaware Valley Geriatrics Education enter

2 EARNING OBJEIVES Direct are Staff will be able to: 4. Identify ways to control plaque in older persons that are functionally dependent and cognitively impaired 5. Identify visible dental problems that should be reported to the nurse or other healthcare provider who might refer to the dentist Delaware Valley Geriatrics Education enter Why is Oral Health Important? Dental disease is common in the nursing home and homebound population Delaware Valley Geriatrics Education enter

3 he mouth is a mirror of health and disease Signs can be seen in the mouth Systemic Disease Bacterial and Fungal Infections Nutritional Deficiencies Delaware Valley Geriatrics Education enter Importance of Dental Health to Overall Health and Well-Being Poor dental health can make other problems worse ardiovascular Disease Diabetes Malnutrition Stroke Pneumonia Delaware Valley Geriatrics Education enter

4 Importance of Dental Health to Overall Health and Well-Being Dental Infections Body Infections Delaware Valley Geriatrics Education enter Importance of Dental Health to Well-being and Quality of ife onsequences of Poor Oral Health Poor self-esteem Decreased social interaction Problems with eating Problems with sleeping Problems with speech Mouth pain Delaware Valley Geriatrics Education enter

5 ommon Dental Problems Seen in ong erm are Gum Disease Dental avities Sores in the Mouth Ill-fitting Dentures ittle Saliva Delaware Valley Geriatrics Education enter Special Problems of Dry Mouth Increase risk of dental cavities, gum disease and infection Difficulty eating Difficulty swallowing Difficulty speaking Altered taste Ill-fitting dentures Delaware Valley Geriatrics Education enter

6 What is PAQUE? Bacteria from food and sweets not completely removed from teeth and dentures on a daily basis causes plaque Plaque starts as a soft sticky film Plaque becomes rock hard (calculus) over time Delaware Valley Geriatrics Education enter onsequences of Plaque Bacteria Gum Disease (Periodontal Disease) leading to tooth loss Dental avities Respiratory Disease It is plaque, not aging, that causes tooth loss Delaware Valley Geriatrics Education enter

7 Direct are Staff are IMPORAN You can prevent the older person s decline in health with daily dental hygiene care Delaware Valley Geriatrics Education enter Daily Mouth are BENEFIS to Older Adults and Direct are Staff Minimize medical problems Enhance quality of life Enhance cooperation Enhance nursing care delivery Delaware Valley Geriatrics Education enter

8 Importance of Dental Health to Overall Health and Well-being Plaque Bacteria Dental Infections Body Infections Quality of ife Delaware Valley Geriatrics Education enter Oral Health are Delivery How can I better provide dental care? Are there special products that will help me to do a better job with daily mouth care? Are there any tips that will help me to provide mouth care for an older person that is uncooperative? Delaware Valley Geriatrics Education enter

9 WE AN ONRO DENA DISEASES Daily Plaque Removal Functional, Physical, and ognitive Impaired Older Adults Delaware Valley Geriatrics Education enter WE AN ONRO DENA DISEASES Older adults with Natural eeth ognitively Impaired Older Adults with Natural eeth Denture are Delaware Valley Geriatrics Education enter

10 SUGGESED PAQUE ONRO Older Adults with Natural eeth oothbrushing Removes plaque on the surface of teeth Soft toothbrush ircular motion Brush for 2 minutes Massage gums Delaware Valley Geriatrics Education enter SUGGESED PAQUE ONRO Older Adults with Natural eeth Flossing Removes plaque between teeth and under the gums Up and down motion areful not to cut into gums Delaware Valley Geriatrics Education enter

11 SUGGESED PAQUE ONRO Brushing and flossing together thoroughly clean teeth and prevent dental cavities, gum disease and tooth loss. Delaware Valley Geriatrics Education enter User Friendly Dental Hygiene Aids Removing Plaque on ooth Surfaces Easier to Do Dental are ollis urve oothbrush Electric and Manual oothbrush Delaware Valley Geriatrics Education enter

12 User Friendly Dental Hygiene Aids Removing Plaque on ooth Surfaces Easier to Do Dental are oothette Delaware Valley Geriatrics Education enter User Friendly Dental Hygiene Aids Removing Plaque Between eeth Stimudents Proxa-brush Floss Holders and Disposable Floss Delaware Valley Geriatrics Education enter

13 User Friendly Dental Hygiene Aids Helps o Keep Mouth Open Safety ontrol omfort Mouth Prop Delaware Valley Geriatrics Education enter User Friendly Dental Hygiene Aids Helps o Keep Mouth Open Make mouth prop ongue depressors Gauze Delaware Valley Geriatrics Education enter

14 IMPORANE of Oral Health are Plaque Bacteria Dental Infections Regular Daily Dental Hygiene are Identify Visible Dental Problems Body Infections Quality of ife Delaware Valley Geriatrics Education enter Older Adults Able to Do Self-are Dental Health are Aids How Direct are Staff an Assist Electric oothbrush Regular oothbrush Floss Holding Devices Make sure dental health care aids are readily available for use Delaware Valley Geriatrics Education enter

15 Older Adults Able to Do Self-are Mild to Moderate Physical Impairment or Mild ognitive Impairment Dental Health are Aids Electric oothbrush Adapted oothbrush ollis urve oothbrush Floss Holding Devices How Direct are Staff an Assist Encourage as much self care as possible Remind often for those with cognitive impairment heck to ensure thorough cleaning Delaware Valley Geriatrics Education enter Older Adults Able to Do Self-are Moderate ognitive Impairment Dental Health are Aids Electric oothbrush Adapted oothbrush ollis urve oothbrush Floss Holding Devices How Direct are Staff an Assist an Follow Directions: onstant reminding Break up the steps for cleaning into simple steps Post step-by-step instructions on mirror and label mouth supplies Delaware Valley Geriatrics Education enter

16 Older Adults Unable to Do Self-are Severe Physical and/or ognitive Impairment Dental Health are Aids Foam Mouth Prop Electric oothbrush ollis urve oothbrush Floss Holding Devices Not Resistant to are How Direct are Staff an Assist Regular time for dental care each day for cognitive impaired Prior to care, explain cleaning process in a gentle and calm manner for cognitive impaired Delaware Valley Geriatrics Education enter Older Adults Unable to Do Self-are Severe ognitive Impairment Dental Health are Aids Foam Mouth Props Gauge wrapped tongue depressor oothette Floss Holding Devices Electric oothbrush ollis urve oothbrush How Direct are Staff an Assist May require two caregivers: One to distract the person and the other to provide care DO NO force care Resistant to are Delaware Valley Geriatrics Education enter

17 DENURE ARE Plaque will also form on dentures and partial dentures Delaware Valley Geriatrics Education enter DENURE SAFEY Dentures should be labeled with the name or initials of the person Dentures are easy to misplace Delaware Valley Geriatrics Education enter

18 Denture Hygiene are Dishwashing Detergent Denture brush or hard nailbrush Running water / washcloth in sink Denture cleaner tablets Denture paste Denture Brush Delaware Valley Geriatrics Education enter Denture Storage ontainer are leaned weekly Diluted bleach Soak 1 hour Rinse thoroughly Delaware Valley Geriatrics Education enter

19 DENURE ARE Dentures should NO be worn 24 hours a day eave out at least 6 hours per day Delaware Valley Geriatrics Education enter Older Adults Able to Do Self-are of Dentures Dental Health are Aids How Direct are Staff an Assist Denture Brush leaning ablets Make sure denture supplies are readily available heck weekly sanitation of denture storage container Delaware Valley Geriatrics Education enter

20 Older Adults Unable to Do Self-are Physical or ognitive Impairment Dental Health are Aids How Direct are Staff an Assist Denture Brush leaning ablets Physically clean dentures daily Remove dentures at night and store in container with water Weekly cleaning of denture container Delaware Valley Geriatrics Education enter Signs of Dental Problems o Report Broken teeth oose teeth Brown areas and dark staining Bleeding gums Ill-fitting dentures Delaware Valley Geriatrics Education enter

21 Early Signs of Oral ancer to Report Swellings Red or White Patches Sores Numbness umps Early oral cancer may be present even without pain Delaware Valley Geriatrics Education enter IMPORANE of Oral Health are Plaque Bacteria Dental Infections Regular Daily Dental Hygiene are Identify Visible Dental Problems Body Infections Quality of ife Delaware Valley Geriatrics Education enter

22 Summary of Objectives You will now be able to: Discuss why good dental health promotes overall health and quality of life Describe the potential benefits to nursing care delivery when daily dental care is maintained Discuss plaque bacteria and how prevention can protect the mouth from damage caused by plaque Identify ways to control plaque in older persons that are functionally dependent and cognitively impaired Identify visible dental problems that should be reported to the nurse or other healthcare provider who might refer to the dentist Delaware Valley Geriatrics Education enter References Guay AH. he oral health status of nursing home residents: what do we need to know? Journal Dental Education 2005; Henry RG. Neurological disorders in dentistry: managing patients with Alzheimer s disease. IDA Journal ;96(4):51-8. Henry RG, Wekstein DR. Providing dental care for patients diagnosed with Alzheimer s disease. Dental linics of North America 1997;41(4): Henry RG, eridan B. Delivering dental care to nursing home and homebound patients. Dental linics of North America 1994; 38(3): Henry RG. Alzheimer s disease and cognitively impaired elderly providing dental care. DA Journal 1999;27(9): Delaware Valley Geriatrics Education enter

23 References Johnson V, halmers J. Oral hygiene care for functionally dependent and cognitively impaired older adults evidence-based protocol. he University of Iowa Gerontological Nursing Interventions Research enter, Research Dissemination ore, National Institute of Dental and raniofacial Research, National Institutes of Health, US Department of Health and Human Services. Oral care for older adults. Information for patients and professionals. National Oral Health Information learinghouse, OP-41, June Oral Health are in the Nursing Facility. American Dental Association ouncil on ommunity Health, Hospital, Institutionalized Medical Affairs. hicago, Illinois. horne SE. Kazanjian A, MacEntee MI. Oral health in long-term care. he Implications of organizational culture. Journal Aging Studies 2001;15: Delaware Valley Geriatrics Education enter eadership and Staff: Kathleen Egan, PhD Series Editor DVGE Program Administrator Director, DVGE University of Pennsylvania Mary Ann Forciea, MD Series Associate Editor linical Associate Professor of Medicine Division of Geriatric Medicine, University of Pennsylvania ois K. Evans, DNSc, RN, FAAN Series Associate Editor Viola MacInnes Independence Professor School of Nursing University of Pennsylvania Sangeeta Bhojwani Associate Director, Series Assistant Editor DVGE University of Pennsylvania Delaware Valley Geriatrics Education enter

24 hank you for your attention! he End Delaware Valley Geriatrics Education enter