How To Help Your Resident Keep That Smile: Part 2

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Did you get a chance to read my post about the importance of providing high-quality dental care in the nursing home? As promised, today I’m sharing a variety of approaches you can use to take excellent care of your residents’ precious teeth.

Staff education

When I worked as a CNA many years ago, nearly every resident arrived at the nursing home wearing dentures. It was unusual to see someone who still had their natural teeth.

Today we see a little bit of everything, including full dentures, bridges, natural teeth, crowns, and implants. Dentures were easy to care for; we simply brushed them and soaked them in water overnight. Now caregivers need to know a lot more about the various options.

Some states require annual in-service training on dental care; others do not. I believe caregivers must receive periodic education by a dental care professional who has experience working with nursing home residents.

Resident education 

I think offering dental education to our residents is equally important. As I mentioned in my previous post, many of our residents grew up in an era when taking good care of their teeth was not a priority. Also, I know many residents are unaware of the link between poor oral hygiene and medical conditions such as pneumonia and cardiovascular disease.

Dental education need not be boring. You could invite a dynamic dental hygienist (armed with dental product goody bags) to come in and talk with a group of residents. Or make dental education a part of celebrating a silly holiday like National Tooth Fairy Day or National Toothache Day.

Adaptive devices

Here’s where an occupational therapist becomes a vital resource. They can assess a resident and recommend a wide variety of adaptive equipment for oral hygiene care.

For example, a resident might have difficulty using a toothbrush for a variety of reasons. These include such things as tremors, stiffness, or weakness. Here’s just one example of the many devices available to help a resident remain as independent as possible.

An electric toothbrush is another option to ensure teeth and gums get cleaned thoroughly. Just know that it can take a few days for a resident to grow accustomed to this type of toothbrush if they’ve never used one before.

Many residents find interdental picks easier to use than traditional dental floss. Another excellent option is floss sticks.

For residents with difficulty swallowing, it could be dangerous for them to swallow water or mouthwash during mouth cares. For these individuals, you can use suction toothbrushes that hook up to a suction machine. Your facility’s speech-language pathologist can help determine if this is appropriate for a specific resident.

Dementia care approaches

As with any personal care, we need to use appropriate communication techniques when working with someone living with dementia. I won’t go into all of these today. However, anyone providing care should receive training in these techniques. (Feel free to use this free printable of communication reminders.)

Depending on the stage of the disease, an individual living with dementia might respond to a variety of approaches. The key here is to try fresh ideas and don’t give up. These are a few suggestions:

• Some people simply need reminders, set-up, and supervision to brush their teeth. A person experiencing dementia might get overwhelmed with the task of brushing their teeth. But if you wet the brush with tepid water, add some toothpaste, and hand the brush to the resident, they can take it from there.
• Gestures often help. I know some CNAs who carry a toothbrush in their pocket and use it to pantomime what they want the resident to do.
• Try different times of the day. If mornings are rough, there’s nothing wrong with brushing teeth after lunch instead. Better late than never!
• Many residents respond best to a small, soft toothbrush. A child’s toothbrush might be helpful.
• You can also try children’s fruit-flavored toothpaste if a resident doesn’t respond well to the strong mint flavor of most toothpaste.
• If you’re using mouthwash, try an alcohol-free brand that doesn’t sting. There are also special products for residents who experience a dry mouth.
• Try a hand-over-hand approach. This allows the resident to feel like they’re brushing their teeth, but you can make sure it’s done thoroughly.

Regulations on dental care

Under federal law (F790 & F791 Dental services), nursing homes must provide routine and emergency dental care for their residents. This sounds good, but there’s a catch. How this care comes about can vary from state to state.

Unless otherwise advised by a medical professional, nursing home residents should receive preventative dental care every 6-12 months, just like the rest of us. If you have questions about how a resident can access professional dental care, I encourage you to speak with your facility’s social worker. Another excellent resource is the ombudsman program in your state.

 

What are your thoughts? I know many of you have other creative ideas, and I would love to see you share them with my readers. Simply leave a note in the comment section!

Update: I’ve received terrific feedback from several of you regarding resources for obtaining free or low-cost dental services. Thank you so much for sharing!

• Judith reminded me that at many dental (or dental hygiene) schools, students provide low-cost dental care under the supervision of instructors.
• Terri shared information about a program called Dental Lifeline Network that provides dental care to people who are elderly, disabled, or medically fragile.
• Shawna suggested people contact their state branch of the American Dental Association for help in finding dental care.