Target: U.S. Department of Health and Human Services Secretary Kathleen Sebelius
Goal: Make proper dental hygiene a priority in nursing homes and improve nurses’ training for dealing with residents suffering from dementia
Nursing homes nationwide are experiencing an “epidemic” of cavities, gum disease, and cracked teeth due to poor routine dental hygiene. Nursing home employees must deal with myriad responsibilities in taking care of their residents, often relegating dental care to the bottom of an ever-mounting daily task list. Employees actually available are often inadequately prepared to provide dental care to residents who “now require more dental care in the past.”
Quoted in the Times, Dr. Sarah J. Dirks, a San Antonio dentist who cares for nursing home residents, says dental hygiene in such facilities is ‘almost universally overlooked.’ Indeed, there are currently no national assessments of dental hygiene in nursing homes. Some states have conducted evaluations since 2011 using surveys from the Association of State and Dental Directors. One Kansas survey reports that the occasional filling notwithstanding, nearly 1/3 of 540 residents in 20 long-term care facilities exhibit untreated tooth decay.
Of particular concern is the lack of routine dental hygiene like cleanings and exams, which face the added barrier of non-coverage by Medicare and limited coverage by Medicaid. According to dental hygienist Shirley Gutkowski, who educates nursing home staff in Wisconsin, nursing home medical directors often fail to see the value in keeping a dentist or even a hygienist on staff.
The consequences for residents with inadequate routine dental hygiene include experiencing incredible pain and discomfort. According to new studies, residents might also face increased risk of pneumonia, a common killer of nursing home residents.
Not to be dismissed, the very intimate nature of having one’s mouth handled makes improved training for nursing home employees essential in order to accommodate the over two thirds of nursing home residents with dementia (not to mention other brain-damaging conditions such as stroke) who may feel uncomfortable with procedures they’re unable to understand and who may clamp their jaws shut or even hit their aides.
The National Institute of Health is researching ways to improve dental hygiene for care-resistant residents suffering from dementia. Please sign the petition below to voice concern over this epidemic and to spur its prioritization in the form of more research and improved training for nursing home staff.
Dear U.S. Department of Health and Human Services Secretary Kathleen Sebelius,
I write urging you to consider the dire epidemic of dental ill health in nursing home residents nationwide. Cavities, cracked teeth, and gum disease abound, a consequence of nursing home staff being overrun with other responsibilities and relegating routine dental hygiene to the back of an ever-mounting daily task list. Nursing home employees who are available too often lack the training to help care-resistant residents suffering from dementia.
Nearly 2/3 of nursing home residents suffer from dementia and other brain-damaging chronic diseases like stroke which, combined with prescription medications, can dry the mouth and pose a risk to oral health. Furthermore, according to new studies, improper dental hygiene puts residents at higher risk of pneumonia, an often fatal disease among long-term care residents. With Medicare’s non-coverage and Medicaid’s limited coverage of routine dental hygiene, this health disparity requires immediate oversight to encourage its prioritization among long-term care facilities.
Various organizations such as the American Health Care Association and the American Dental Hygienists Association recognize the severity of this epidemic. With the former being a trade group representing 2/3 of nursing homes nationwide, these groups hold potential to enact improvement in residents’ dental hygiene. Finally, we must change the nursing home culture itself. Many nursing home medical directors still fail to see the value in having a dentist or even a hygienist on staff. Tackling this barrier, along with improving training for staff in efficiency and in care-resistant resident interaction, must be priorities.
Please help in laying the groundwork for these changes and leading the way in eliminating these communities’ health disparity.
[Your Name Here]
Photo Credit: Ulrich Joho via Flickr