A group of nursing home residents was asked what was most important when it came to  their daily routine. They said 2 things: getting their hair combed and their teeth brushed. These are simple, basic needs that can easily be addressed and should not be overlooked. It only takes a minute to comb someone’s hair but it can make a big difference.

A recent article about caring for people with Alzheimer’s disease found that “helping a person with dementia maintain his or her appearance can promote positive self-esteem.” [1]

Routine oral care is important in promoting positive self-esteem and as a way to treat our dependent elderly with dignity and respect. However, it’s also an important factor when it comes to reducing the risk of infection, even death. You wouldn’t go more than a day without brushing your teeth. Your residents deserve the same.

Yoneyama et al. (2002) found that residents who received regular oral care were less likely to develop pneumonia, had fewer febrile days and were less likely to die from pneumonia. [2]

Oral care needs to be done regularly because dental plaque contains bacteria and once plaque gets on your teeth, it hardens very quickly (within 48 hours).[3] Bacteria entering the lungs due to aspiration is a potential source of infection.  Langmore (1998) found that being dependent on others for oral care was a predictor of developing aspiration pneumonia.[4]  Some residents just need verbal reminders, others need more assistance.

If a resident needs help, it’s up to us to provide it.  “Us” is anyone caring for that person, whether it’s an RN, nursing aide, OT or SLP. It’s our job. See the link below for tips on how to assist someone with dementia with oral care:

http://www.alz.org/care/alzheimers-dementia-dental.asp

 

Here is a basic protocol for oral care:

Teeth brushed 2x/day

Dentures – also cleaned 2x/day (removed at night, cleaned and soaked overnight in denture cleansing solution –  EVERY night)

Electric toothbrushes and suction toothbrushes can be helpful

Swabs (toothettes) should NOT be used in place of brushing teeth – they do not do an adequate job of cleaning the mouth

Note – if you are using swabs to keep the mouth moist, use them one time only and then throw them away – do NOT replace them in a cup of water at bedside (this might seem like common sense, but I see this happen so often, I had to mention it)

 

Routine oral care will help reduce the risk of infection.  Making oral care a priority and using a team approach will help maintain the health and quality of life for our elderly residents.

 

 

[1] https://www.alz.org/care/alzheimers-dementia-dressing.asp

 

[2] Yoneyama, Takeyoshi DDS, PhD., et al. (2002). Oral Care Reduces Pneumonia in Older Patients in Nursing Homes. Journal of the American Geriatrics Society, 50, 430-433. Retrieved July 12, 2016 from http://onlinelibrary.wiley.com/doi/10.1046/j.1532-5415.2002.50106.x/abstract;jsessionid=293B08DEA79B5E0C5D9052DD66874F76.f03t02?userIsAuthenticated=false&deniedAccessCustomisedMessage=

 

[3] Retrieved July 12, 1016 from https://www.humana.com/learning-center/health-and-wellbeing/healthy-living/dental-plaque

 

[4] Langmore, S. E., PhD, et al. (1998). Predictors of Aspiration Pneumonia: How Important is Dysphagia? Dysphagia, 13, 69-81.

 

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