My uncle John was a large influence on my life. He passed down his passion and love for education to me. He lived to be 86 years old and spent his last year in an Alzheimer’s care unit in a Maine nursing home. While he was there, he received compassionate support from the staff — but an area that was lacking was oral care.
As a student in the dental hygiene program at the University of New England in Biddeford and Portland, I have learned that proper oral health is important for physical and mental health. After researching geriatric dental care, I have come to believe that the lack of oral care in Maine’s long-term care facilities — and across the country — is an epidemic. In addition to correct medications and a supportive living environment, compassionate care for our elders in nursing homes must include careful attention to oral health.
A study published in the Journal of American Geriatric Society in 2006 looked at five long-term care facilities in upstate New York. The study found that only 16 percent of residents received any oral care at all. For those who did, the average tooth brushing time was only 16 seconds. This study, and my interest in health care for the aging population, motivated me to build a team of University of New England students dedicated to improving oral hygiene in nursing home facilities across Maine.
I reached out to students in the dental hygiene, pharmacology and occupational therapy programs, each of whom contributed a unique perspective to the project. Fellow dental hygiene students Cassidy Banville, Carolyn Dacey and Sarah Fogg were eager to participate in order to gain experience working as part of an interprofessional team. In our program, we are primarily focused on oral health care, but by working with pharmacy and occupational therapy students, we have gained a more comprehensive view of geriatric health needs. This has enabled us to become better patient-centered practitioners, improving the quality of care for individuals.
My teammate Casey Fisher from the College of Pharmacy works to educate nursing home staff on the specific effects that certain drugs have on oral health. Medications often used by the geriatric population — including tricyclic antidepressants, antispasmodics and some antipsychotic drugs — can cause dry mouth. The lack of saliva flow caused by such medications has a direct correlation with cavity rates, as teeth are not buffered from acid-causing bacteria.
Collaborators Kelly Dolyak and Heather Smith of the Department of Occupational Therapy discuss ways to make oral hygiene more accessible for those with physical disabilities, cognitive disabilities or both. They show staff ways to adapt the task or environment, empowering the individual to be as independent as possible despite their limitations. In turn, this promotes long lasting health and wellness.
In January 2016, my interprofessional team completed our first staff training at Gorham House nursing home in Gorham. We provided six hours of training and received very positive feedback from Activity Director Donna Davis, who invited us to return for another session this winter. Donna emphasized how much she and her staff care for the residents, and that they were grateful to learn how to provide the best care possible for those at Gorham House.
Treatment for the elderly often is sought out only when they experience pain. Development and maintenance of an oral hygiene program is a critical step to prevent systemic disease and discomfort. By providing interprofessional, team-based training to health care providers and nursing home staff, I believe that we can positively impact the health of residents in these facilities.
Regina Arey is a fourth-year dental hygiene student at the University of New England in Portland.