WRITING SAMPLE

Is It Time to Bring Dental Care Back to Your Facility?

As the COVID-19 pandemic reaches its second year, providers are learning how to balance the requirement for increased infection control measures with the necessities of attending to their patients’ non-viral health needs.

In March of 2020 the American Dental Association (ADA) was one of the first health professional organizations to call for a halt to non-emergency care so that experts could take time to study the situation. Recently however, the ADA – backed up by the CDC 1 – has not only issued science-based guidelines for resuming care but has reminded all of us just how important dental care is to maintaining systemic health.

And this is especially true for seniors.

The Risks of Delaying Oral Health Measures

Skilled nursing facility caregivers were concerned when an 84-year-old resident began exhibiting aggressive behaviors, including hitting, spitting and sexual disinhibition. He appeared to be in some sort of discomfort but, suffering from advanced stages of Alzheimer’s disease, was unable to communicate. Physicians worked to understand how his other conditions (diabetes, hypertension and chronic kidney disease) could be influencing his behavior but medication adjustments and other treatments provided no lasting change.

After two years, the man had begun biting his own hand, causing significant lacerations. Eventually a dentist performed an exam and removed three cavities. After extraction, the resident’s antisocial behavior abruptly stopped. Years later, his behavior remains “pleasant,” according to a paper detailing the case.

The inarticulate suffering of this gentleman is an example of the avoidable risks that can come with neglected oral health. Preventative care and treatment for dental disease, while it’s still in early stages, helps mitigate a variety of risks, including:

1. Systemic Infections. A review of the research around the link between oral health and infection in elderly residents of chronic care facilities finds that “limit[ing] oral infections will go far to reduce hospital admissions from chronic care facilities and even lower the mortality rate related specifically to systemic bacterial infections in these patients.”

2. Complications from Dysphagia. “Proper Oral Care Can Reduce Risk of Pneumonia,” an article published in RT magazine, encourages skilled nursing facilities to educate staff on the importance of oral health, noting the risk of hospital admissions for residents with oropharyngeal dysphagia. This condition hinders the ability to swallow and can lead to serious consequences, including aspiration pneumonia, malnutrition, dehydration, choking, or death. “Effective oral care has been widely accepted as a crucial component in the reduction of aspiration pneumonia, but still, it is often overlooked,” the article states.

3. General Decline of Good Health. Analyses reported in a 2019 study, “Oral Health as a Gateway to Overall Health and Well‐Being: Surveillance of the Geriatric Population in the United States,” shows “statistically significant relationships between oral health, physical, mental and general health, energy levels, depression, and appetite. Out of the 10 systemic diseases being investigated, six of them were directly related to oral health outcome.”

CDC and ADA Compliant Dental Care is Critical for Seniors

Leaders in skilled nursing facilities should be mindful that according to both the CDC and ADA, dental care can be provided safely. Delaying that care can create significant risk for elderly residents.

__________________________

Citations

1 https://www.ada.org/en/press-room/news-releases/2020-archives/august/american-dental-association-dentistry-is-essential-health-care
2 https://onlinelibrary.wiley.com/doi/10.1111/j.1479-8301.2011.00374.x
3 https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1741-2358.1988.tb00318.x
4 https://rtmagazine.com/disorders-diseases/infectious-diseases/pneumonia/proper-oral-care-
pneumonia/
5 https://onlinelibrary.wiley.com/doi/abs/10.1111/scd.12385