In Nursing Homes, an Epidemic of Poor Dental Hygiene

by:HongXing     2020-08-08
Catherine Ford visited her father Dean Piercy in a nursing home in varronock, a World War II veteran with dementia.
A few months before she noticed the dust on his plastic toothbrush
She found that his teeth had not been brushed recently, so she began brushing her teeth herself after they had lunch together.
But she said she pestered the staff to make an appointment for him after he complained about a severe headache and continued.
The dentist found that both teeth were broken and he showed her.
Ford was stuck in the part of her father\'s mouth.
\"I am very angry,\" said the lady . \"
Ford, 57, is a court reporter.
It was there every day, pointing out that he was in pain and that he had dental insurance.
So there is no reason for this problem to be solved.
In nursing homes across the country, residents like Mr.
Piercings are plagued by tooth decay, gum disease and cracked teeth, in part because their mouths are not kept clean.
While residents now need more dental care than in the past, staff in nursing homes are rarely prepared to provide dental care.
The assistant is busy with other tasks and when the old fee has to help with the toilet, feeding or repositioning on the bed, brushing usually falls belowdo list.
Even with care, few staff are trained to cope with the daily oral hygiene of an increasing number of people with dementia.
I always say that you can measure the quality of a nursing home by looking at people\'s mouths, because this is one of the last things to deal with, says Dr. Judith A.
Jones, head of General Dentistry at Boston University.
The assistant changes the catheter or turns once every few hours, but the teeth don\'t usually brush twice a day.
Neglect will bring terrible pain to the residents.
To make matters worse, new research suggests that this problem may be the cause of another problem: pneumonia, which is the main killer that causes the elderly to be hospitalized.
The lack of daily oral care in nursing facilities is an epidemic that is almost universally overlooked, he saidSarah J.
Dix is a dentist who treats residents of a nursing home in San Antonio.
There is currently no national assessment of oral health in nursing homes, but since 2011, at least seven states have used a survey developed by the Association of State and district dental directors to assess residents.
One of them was Kansas, where the dental staff examined 540 elderly residents in 20 cities. term-Nursing facilities.
Nearly 30% of residents have at least two large amounts of oral garbage.
According to a report released by the Kansas Oral Health Bureau, they have 30 teeth. More than one-
The third is untreated decay.
The inspectors saw a large number of fillings and crowns, but concluded that regular dental care had become a tradition for many residents.
In Wisconsin, nearly 1,100 residents from 24 families were examined.
About 31% of the teeth are broken by the gums, and the roots are visible;
There is a large amount of oral debris in 35%.
State and federal inspections of nursing homes have documented the problem in graphical form.
In Texas, inspectors noticed that a resident with a memory problem was eating too much pain, her lower gums were red and swollen and filled with food debris.
A study of 2006 of five facilities in northern New York found that only 16% of residents had received any oral care.
The average brushing time is 16 seconds.
The report says there are very few items like toothbrushes.
At the Raleigh court Health and Rehabilitation Center in Roanoke, where Mr.
Chief executive Mark Tubbs said in a statement that he could not discuss Mr Piercy.
For reasons of the federal privacy law, he was unable to confirm the case of Piercy.
Ford\'s account.
All patients receive the necessary medical High.
Quality care including oral care and hygieneTubbs said.
Just like the staff of the nursing home should help residents to take a bath or relocate to avoid bedridden, they should brush their teeth on their own.
This task is so important that the federal government authorized it in the Consolidated Budget Reconciliation Act of 1987, which sets new standards for nursing homes.
They should be taken care of by them, but a lot of people don\'t know.
David Gifford, senior vice president of quality at the American Health Care Association, one representative for two-
Nursing homes nationwide.
He pointed out that some residents refused to help and there was nothing the staff of the nursing home could do about it.
It\'s a very personal thing to have someone else brush their teeth, doctor. Gifford said.
Many residents don\'t want it, they don\'t like it, they will ask for it.
He added that many people arrived at a nursing home with bad teeth without going to the dentist for a long time.
Of course, oral care can be a tricky challenge for nursing homes.
Older Americans are more likely than ever to retain natural teeth.
According to data from the National Health and Nutrition Examination Survey, tooth loss in the elderly decreased from 1988 to 2004.
\"Before, they came in with fake teeth,\" said Barbara J . \"
Smith, senior and special manager
The demand population of the American Dental Association.
Now, it\'s a completely different game.
The staff of the nursing home are easier to clean the dentures. Nearly two-
People in their thirties who have been in nursing homes for a long time have dementia, and many resist oral care, close their mouths, and even try to play assistants.
The National Institutes of Health are funding research to address this resistance among people living in nursing homes with dementia.
Many prescription drugs, including some anti-depression drugs, high blood pressure drugs and anti-depression drugs
Epilepsy drugs can reduce saliva and dry the mouth.
Without daily oral care, the elderly who take the drug are particularly prone to a relatively rapid deterioration, the doctor said.
Ira Lamster is a professor of dentists and health policy at the School of Public Health at Columbia University postman.
The consequences are not limited to tooth decay and gum disease.
Starting from 2004, when researchers first linked oral bacteria to the occurrence of the hospital,
Acquired pneumonia in the elderly, a series of studies have shown that oral care may reduce risk from regular brushing of teeth to professional dental care.
According to the 2008 systematic review published in the Journal of the American Institute of geriatric medicine, about one in ten cases of pneumonia deaths in nursing homes can be prevented by improving oral hygiene.
But even if residents and their families know that better oral care is needed, paying for it is a challenge.
Medical insurance does not include routine dental care such as cleaning and filling.
Most states provide at least some dental services to adults on Medicaid, but the coverage varies greatly and it can be difficult to find local dentists who receive Medicaid payments.
According to the American Association of Dental healers, more than 30 states allow dental healers to provide some treatment without the special authorization of the dentist.
But the medical director of the care facility does not necessarily think that there is any value to a dental care worker with a contract or an employee, said Shirley guokowski, a 27-year-old dental care worker who educated care-
Domestic workers in WisconsinDr.
Texas dentist Dix said she would be surprised if oral care even appeared on the radar of the medical director of the nursing home.
In fact, her group practice once contracted with 62 nursing homes, but now only works with 24 nursing homes that make oral health a priority.
To change, she said, a champion of oral care is needed in every nursing home.
Catherine St. Louis talks about why daily oral care in the care facility is almost universally overlooked and why it causes complications that are dangerous to residents.
A version of this article appears on page 08/06/2015 of The New York edition D1, with the title: The nursing home ignores the teeth.
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