In nursing homes, an epidemic of poor dental hygiene

From the Well blog at the New York Times:

Katherine Ford visited her father, Dean Piercy, a World War II veteran with dementia, at a nursing home in Roanoke, Va., for months before she noticed the dust on his electric toothbrush. His teeth, she found, had not been brushed recently, so she began doing it herself after their lunches together.

But after he complained of a severe, unrelenting headache, she said, she badgered the staff to make an appointment for him with his dentist. The dentist found that a tooth had broken in two, and he showed Ms. Ford the part that had lodged in the roof of her father’s mouth.

“I was livid,” said Ms. Ford, 57, a court reporter. “I’m there every day, pointing out he’s in pain — and he had dental insurance. So there’s no reason this wasn’t addressed.”

In nursing homes across the country, residents like Mr. Piercy are plagued by cavities, gum disease and cracked teeth, in part because their mouths are not kept clean. While residents now require more dental care than in the past, nursing home employees are rarely prepared to provide it. Aides are swamped with other tasks, and when older charges must be helped to the toilet, fed or repositioned in bed, brushing their teeth often falls to the bottom of the to-do list.

Even when care is available, few staff members are trained to cope with the rising numbers of residents with dementia who resist routine dental hygiene.

“I always say you can measure quality in a nursing home by looking in people’s mouths, because it’s one of the last things to be taken care of,” said Dr. Judith A. Jones, chairwoman of the department of general dentistry at Boston University. “Aides change someone’s Depends, change a catheter or turn somebody every few hours, but teeth often don’t get brushed twice a day.”

The neglect can lead to terrible pain for the residents. Worse, new studies suggest that this problem may be contributing to another: pneumonia, a leading killer of  institutionalized older people.

Read the complete post here.

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