All about teeth Issues Around Oral Health

Transcription

1 All about teeth Issues Around Oral Health Oral Health Challenges in Long-term Care Access to Oral Care Mickey Wener, RDH, MEd School of Dental Hygiene Health Promotion Unit, Centre for Community Oral Health Faculty of Dentistry, University of Manitoba 1

2 Oral disease ~ an epidemic in Long-term Care Residents often: Are living longer with many health issues Have their own natural teeth Do not think they need dental treatment, nor do their families Do not have dental coverage and cannot afford dental care Take medications that make their mouths dry Enter long term care with dental problems Depend on others for daily mouth care, supplies & professional visits Are unable to cooperate Caregivers care, but often: Have many responsibilities Have not received mouth care training Personal care homes often: Do not have mouth care policies and/or may not enforce them Oral health professionals often: Are focused on private practice Have little public funding to support oral health services & care for this population 2

3 Dental Plaque Is an organized BIOFILM Contains over 300 types of microorganisms Grows on teeth, tongues, dentures, and all tissues even if tube-fed Needs to be removed daily to maintain health If not brushed off, it hardens into calculus Calculus (tartar) must be removed by a dental professional Sticky dental plaque plays a key role in both tooth decay & gum disease 3

4 TOOTH DECAY Bacteria + Food = Acid Acid + Tooth = DECAY Plaque Bacteria Carbohydrate Sugar Challenges: Poor daily mouth care Frequent meals Sugary treats, candies, lozenges Dry mouth Boost/Ensure Sweetened medications Exposed tooth roots Tobacco use Tooth Every dose of sugar = 20 minute acid attack Dry mouth = 2 hours! 4

5 GUM (periodontal) DISEASE An infection that destroys the bone around teeth Can cause tooth loss = trouble eating & malnutrition Signs: bleeding, pus, loose teeth, bad breath, bad taste, itchy gums Not necessarily painful Preventable with good care! Challenges: Poor daily mouth care Poorly controlled diabetes Smoking Dry mouth Weak immune system Did you know? Gum disease throughout the mouth = an open wound the size of your forearm 5

6 Reconnect the Mouth to the Body! Research increasingly supporting links between oral health and Diabetes Poor sugar control increased the risk for decay & gum disease Gum disease can make it hard to control blood sugar levels Cardiovascular Disease Stroke strongest link Mouth bacteria have been found in diseased arteries AND 6

7 Aspiration Pneumonia Aspiration of mouth & throat secretions main cause of pneumonia; leading cause of death in LTC Research has correlated aspiration pneumonia with: Dysphagia Impaired cough reflex sensitivity Compromised health Poor management of oropharyngeal secretions Dependent in feeding Recent antibiotic therapy AND NOW Periodontal (gum) pathogens Poor dental plaque control Xerostomia dry mouth Having natural teeth, especially with untreated tooth decay Poor daily mouth care increases the risk for pneumonia! Respiratory infections greatest issue in recent study of 6 diagnostic quality indicators for Manitoba personal care homes Russell et al. (1999); El-Solh (2003, 2004); Terpenning (2001); Scannapieco & Mylotte (1996);Scannapieco et al. (1998); Imsand et al. (2002); Manitoba Centre for Health Policy (2006) 7

8 Mouth Care = Infection Control Residents have a right to mouth care! Neglect can lead to serious health risks It s not just grooming it s an Activity of Daily Living that s critical to health! It s a 2-minute clinical intervention Mouth care exposes you to resident s saliva, blood & germs! Wear well-fitting gloves for all mouth care with teeth, no teeth, screening Candidiasis yeast infection 8

9 Products for extra help Foam toothettes do not remove plaque! 9

10 Clues that there may be a dental problem Pain & discomfort From infection, mouth sore, tooth decay or broken denture/partial Problems Speaking or wearing dentures Eating, digesting foods or enjoying favorite foods Sleeping Social issues Embarrassed & avoiding laughing or smiling Bad breath that is keeping away caregivers & others Health problems Inability to gain weight or weight loss Reoccurring pneumonia or diabetic s inability to control blood sugar 10

11 Oral care in personal care homes: The BIG PICTURE All staff receive on-going oral care education Everyone in the facility is on board & supportive Policies & protocols in place, updated and enforced Mouth care products are available Effective daily mouth care is provided Oral screening & referrals are part of the assessment routine Caregivers connect with family/guardian about oral health Residents have access to professional dental care Legislation requires oral care in personal care homes & promotes access to professional care Every facility needs a champion for oral health care! 11

12 ACCESS TO CARE ~ U of M Home Dental Care Program Operated by the Centre for Community Oral Health, Faculty of Dentistry 2 dental mobile vans bring care to personal care homes, senior citizens residences, hospitals and private homes New patients receive initial examination at no charge. Prior to receiving any further services or treatment, written estimates are provided. Care includes check-ups, preventive care, fillings, extractions, and dentures For an appointment or more information: THE HOME DENTAL CARE PROGRAM DEER LODGE CENTRE Phone: (204) nd Floor Portage Ave. 12

13 ACCESS TO CARE ~ U of M Deer Lodge Centre Dental Clinic Operated by the Centre for Community Oral Health, Faculty of Dentistry Provides dental services for the residents of DLC, seniors, DLC staff and individuals within the surrounding communities For an appointment or more information: DEER LODGE CENTRE DENTAL CLINIC 2 nd Floor Portage Ave. Tel:

14 ACCESS TO CARE ~ U of M CCOH Health Promotion Unit School of Dental Hygiene Dental hygienists provide: Clinical care at CCOH sites Mouthcare training for caregivers Mouthcare policy consultation On-line evidence-based fact sheets The Dental Hygienists Act Potential for increased access to oral care Screening, referral, preventive & therapeutic services MOUTHCARE FOR CAREGIVERS Friday May 11, 8:30-12:30 Faculty of Dentistry Teaching Lab Registration $

15 Enjoy eating nutritious foods Improve overall health Ouch! Prevent dental disease & pain Save money Provide effective daily mouth care to Detect other problems Feel good Reduce treatment needs Prevent bad breath 15

16 Oral care in long-term care resources On-line University of Manitoba Oral Health Promotion Fact Sheets for Long-term Care: Mouth care video: The How To s: The Maintenance of Oral Health Standard, Modules 1-9, Dec 2003, 34 minutes, Fraser Health Unit, British Columbia National Oral Health Information Clearing House: Oral hygiene care for functionally dependent and cognitively impaired older adults at: 16

17 Dental Hygienists: Carol Yakiwchuk, Mary Bertone, Laura MacDonald School of Dental Hygiene & The Centre for Community Oral Health Faculty of Dentistry University of Manitoba Dr. John Morreale, select photos 17