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Anthony Cirillo

Are You Watching Out for Your Residents' Dental Health?

By January 4, 2013

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People who keep their teeth and gums healthy with regular brushing may have a lower risk of developing dementia.

Researchers followed close to 5,500 elderly people over an 18-year period. Women who reported brushing their teeth less than once a day were up to 65 percent more likely to develop dementia. Inflammation from gum disease-related bacteria impacts heart disease, stroke and diabetes. Gum disease bacteria might get into the brain causing inflammation and brain damage, researchers told Reuters Health.

Participants ranged in age from 52 to 105, with an average age of 81. All were free of dementia at the outset, when they answered questions about their dental health habits, the condition of their teeth and whether they wore dentures. Researchers followed-up 18 years later, using interviews, medical records and in some cases death certificates to determine that 1,145 of the original group had been diagnosed with dementia.

Men were less affected. The less frequent brushers were 22 percent more likely to have dementia than those who did brush daily. Statistically, however, the effect was so small it could have been due to chance, the researchers said. There was a significant difference seen between men who had all, or at least most, of their teeth, or who wore dentures, and those who didn't - the latter group were almost twice as likely to develop dementia. That effect was not seen in women.

Geriatric dentistry or gerodontics is the delivery of dental care to older adults involving the diagnosis, prevention, and treatment of problems associated with normal aging and age-related diseases as part of an overall health program. The mouth is referred to as a mirror of overall health, reinforcing that oral health is an integral part of general health. In the elderly population poor oral health has been considered a risk factor for general health problems. On the other hand, older adults are more susceptible to oral conditions or diseases due to an increase in chronic conditions and physical/mental disabilities. Thus, old people form a distinct group in terms of provision of care.

The TRECS Institute ("Targeting Revolutionary Elder Care Solutions") did work in this area and made these recommendarions:

  1. There is a profound and basic need to develop a program to educate all cohorts including residents, family and health care professionals on the importance of good dental and oral care for the elderly.
  2. Long-term care professionals should implement a preventive oral screening program consisting, not only of entrance examinations but also routine (daily) preventive care, with special training of staff for challenging patient types.
  3. A dental insurance program designed specifically for nursing home residents should be tested as a realistic approach to improving dental care services by increasing reimbursement for dental professionals thereby eliminating the access problem that dominates the industry today.
  4. The use of dental hygienists should be expanded within the nursing home setting by allowing collaborative relationships with dentists similar to the relationship nurse practitioners share with their collaborating physician in many States.
  5. Taking the appropriate efforts to improve oral and dental care for nursing home residents could have a significant impact not only on quality of life for nursing facility residents, but also a meaningful impact on downstream medical costs for the health care system by preventing hospitalizations and death resulting from medical care needs arising out of poor oral and dental care.
  6. The need for better education and preventive dentistry also needs to be stressed for the senior population in general, especially those retiring from active employment long before nursing home placement possibilities.

What are you doing in this area for residents? Please share best practices. Thanks.

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