How To Help Your Resident Keep That Smile

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Recently I asked my newsletter subscribers for suggestions as to topics they would like to see addressed on my blog. One reader requested that I write a post about dental care in nursing homes.

This reader expressed concern that the staff doesn’t help her mom brush her teeth as often as they should at the nursing home. She shared that her mom has taken excellent care of her teeth all of her life. Now she fears her mom could lose her beautiful smile.

• Why does this happen?

Staffing issues

I worked as a CNA in nursing homes during high school and college. Also, I worked for many years as an RN in a few long-term care facilities.

So I know from personal experience that dental care is often overlooked. Unfortunately, when caregivers are understaffed or overworked, thorough mouth care easily falls by the wayside.

Generational attitudes

Many of our residents come from a generation that accepted cavities and loss of teeth as an unavoidable part of life. While growing up, they didn’t learn the importance of brushing and flossing their teeth. Also, many didn’t seek routine professional dental care.

Medication side effects

Many medications cause dryness in the mouth. These include certain antidepressants, diuretics, antihypertensives, and pain medications.

Adequate saliva is important because it neutralizes acids in the mouth that can damage teeth. It also decreases harmful bacteria. As a result, residents with this condition need extra vigilant dental care.

Impaired communication

Imagine what it would be like to have a bad toothache and not be able to tell anyone about it or get help for the pain. This can happen to people living with dementia or residents with other communication impairments.

Resistance to mouth care

Residents living with dementia often resist help with brushing their teeth. They don’t understand what you’re trying to do. Many will also not understand what’s happening when they go to the dentist.

Lack of funds

I once worked at a nursing home where we had great difficulty finding dentists who would see our residents. Medicaid reimbursement was so poor that dentists didn’t feel it was worth their time. Thankfully, we eventually found a nonprofit mobile dental service that now provides basic care.

Even for residents who do not rely on Medicaid, dental services are expensive. As a result, some people choose not to make dental care a priority.

Medical conditions

A variety of medical conditions can negatively impact dental care. For example, someone with arthritis in their hands might have difficulty brushing their teeth thoroughly. Perhaps a resident with memory loss might simply forget to brush their teeth.

Diabetes reduces a person’s resistance to infection, which could lead to gum disease. Another example is osteoporosis, which can lead to loss of bone structure in the jaw and loss of teeth.

Tobacco use

Many of our residents come from a generation where smoking and the use of chewing tobacco were a part of everyday life. They weren’t aware of the long-term hazards like we are today. As a result, these people are at higher risk for gum disease, oral cancer, and tooth decay.

• Why does this matter?

Poor mouth care leads to a litany of problems. These are a few of the most common ones:

Social isolation

Bad breath because of poor mouth care easily affects social relationships. Also, embarrassment due to missing or damaged teeth might result in a resident avoiding social situations.

Pneumonia

Bacteria from the mouth are breathed into the lungs, putting a resident at higher risk for developing pneumonia. This is especially true when a person has difficulty swallowing or when their immune system is compromised.

Challenging behaviors

When a resident who lives with dementia experiences mouth pain, they might react with changes in their mood or behavior. This could cause restlessness, aggression, withdrawal, or sleeplessness.

Poor nutrition and weight loss

Mouth pain and difficulty chewing often cause inadequate food intake. This, in turn, leads to excessive weight loss and possibly dehydration.

Cardiovascular disease

Tooth and gum disease results in harmful bacteria entering the bloodstream. It then travels throughout the body. This leads to the build-up of plaque in the arteries. As a result, a resident’s risk of heart attack or stroke increases.

• So, what are we to do? 

Come back here next week, and I’ll share lots of strategies to help you provide excellent dental care for your residents. In the meantime, can you think of other blog topics that would be helpful to you? If so, simply leave a note in the comment section.