In nursing homes across the country, residents are plagued by dental problems—cavities, gum disease, and cracked teeth—because their mouths are not kept clean.
Nursing home employees swamped with other tasks often don’t have time to provide regular tooth care for residents, The New York Times reports. Aides must help with feeding, dressing, toilet use; tend to catheters and other medical equipment; help residents in and out of bed. Tooth brushing often falls to the bottom of the daily care list. In many facilities, staff members are not trained to handle dementia patients, who often resist dental care.
The neglect of oral hygiene can take a terrible toll on residents, in pain from cavities, broken teeth, and gum disease; in the inability to eat properly; and in infections, including pneumonia, that can start with oral bacteria that proliferate when dental hygiene is neglected, according to the Times Well blog.
Since 2011, a number of states have evaluated residents’ oral health using a survey developed by the Association of State and Territorial Dental Directors. In Kansas, when dental hygienists examined 540 older residents in 20 long-term-care facilities, nearly 30 percent of them had “substantial oral debris on at least two-thirds of their teeth,” according to the Kansas Bureau of Oral Health. More than one-third had untreated decay. Similar problems were documented in other states, including Texas, New York, Wisconsin, and Virginia, the Times reports.
Nursing home residents with dementia often clench their jaws shut to prevent tooth brushing — or even hit or shove aides who try to brush their teeth. Other residents simply do not want someone else brushing their teeth and refuse this care, although they cannot do it properly themselves. Some prescription drugs cause dry mouth, which can lead to dental problems if daily oral care is inadequate.
Dr. Sarah J. Dirks, a dentist who treats nursing home residents in San Antonio, Texas said the lack of daily oral care in nursing facilities is “an epidemic that’s almost universally overlooked,” according to the Times. Every nursing home, she says, “needs an oral care champion.”