October 27th 2014

1. Better Oral Care
in Long Term Care
Best Practice Standards in Saskatchewan
Saskatchewan Oral Health Coalition
October 27, 2014
Better Oral Care in Long Term
Care

2. Historically…
Better Oral Care in Long Term Care

3. History of Saskatchewan Oral Health
Projects in Long Term Care
o Dental Health Educators working within
their health regions have provided
assistance to LTC patients and/or staff.
o Individual dental therapists were providing
care in a few homes.
Better Oral Care in Long
Term Care

4. History of Saskatchewan Oral Health
Projects in Long Term Care
o In 2005 team discussions occurred.
o In 2007 the CDSS initiated the “Senior Oral
Services (S.O.S.)” project.
o 2008 – “Access to Care” seminar.
Better Oral Care in Long Term
Care

5. History of Saskatchewan Oral Health
Projects in Long Term Care
In 2006 the SDAA proposed a
“Dental Assistant Care Plan” for LTC”
 Radiography (if available)
 Fluoride
 Oral hygiene instructions
 Place Provisional Restorations
 Desensitizing
 Labeling dentures
 Remove sutures, etc.
Better Oral Care in Long Term
Care

6. History of Saskatchewan Oral Health Projects
in Long Term Care
College of Dental Surgeons of
Saskatchewan
2007-2008
Regina: Saskatoon:
Santa Maria Senior Citizens Home St. Ann’s Senior Citizens Home
Full Dental Operatory Portage Dental Equipment
Dr. Maureen Lefebvre Dr. Raj Bhargava
Better Oral Care in Long Term Care

7. Better
Oral Care
in Long
Term
Care

8. Initiatives such as
poster’s were sent
to each LTC home in
Saskatchewan
advocating oral care
Better Oral Care in Long Term
Care

9. History of Saskatchewan Oral Health
Projects in Long Term Care
Saskatchewan Dental Hygienists
Association
o Skill set
o Workplaces
o Oral Systemic Link
o Diabetes Link and Perio Brochure
Better Oral Care in Long
Term Care

10. Saskatoon Oral Health Coalition
o May, 2010 Coalition formed
o May, 2011 Oral Care in Long Term
Care was identified as a significant
goal
o (transcended to Saskatchewan Oral Health
Coalition – 2013)
Better Oral Care in Long Term Care

11. Steering Committee - SHR
In 2011, the Saskatoon Health Region and the U. of S
College of Dentistry partnered with Santa Maria and
St. Ann’s, (Community Wellness Grant) to provide:
o administration
o human resources (dental assistant)
o Operation of a pilot project for oral health care
Better Oral Care in Long Term
Care

12. Project Overview:
o provided education to long term care staff at two
long term care homes.
o Residents and their families were surveyed on basic
oral health information.
o The dental assistant works in two long term care
homes and facilitates treatment by:
Getting clients to the dental suite
Assists the dentist visiting the home
Works with staff to promote daily oral care
Better Oral Care in Long Term
Care

13. Saskatchewan Oral Health Professions
o January, 2012
o Saskatchewan made Long Term Care Strategy
o Our strategy would be based on the ‘best
practices’
o Present our strategy to the Saskatoon Oral Health
Coalition… health district personnel…
Saskatchewan Health
Better Oral Care in Long Term
Care

14. Saskatchewan Oral Health Professions
o College of Dental Surgeons of Saskatchewan
o Saskatchewan Dental Therapists Association
o Saskatchewan Dental Hygienists’ Association
o Saskatchewan Dental Assistants’ Association
o Dental Director, Saskatoon Health Region
Better Oral Care in Long Term Care

15. Collaboration:
o The committee developed a proposal for a LTC Strategy for
presentation to Saskatchewan Health;
o Reviewed “best practices” in LTC from around the world;
o Acquired access to the Australian model to be amended to reflect
our model for care;
o Secured funding from the SOHP Conference fund to contract
development;
o Hired a Masters in Public Health to develop the proposal
/presentation.
Better Oral Care in Long Term
Care

16. SOHP Overall Strategy:
o Resources made available to every health
region
o Resources made available to every long
term care home in Saskatchewan.
o Endorsed by government
Better Oral Care in Long Term
Care

17. SOHP Goal #1
That the Saskatchewan Government, Ministry of
Health endorse the Saskatchewan Seniors Oral
Health and Long Term Care Strategy developed by
the Saskatchewan Oral Health Professions
collaboratively with Long Term Care.
Better Oral Care in Long Term
Care

18. SOHP Goal #2
That legislated Oral Health Care Policies/Standards for Long Term
Care and Personal Care Homes are established based on best practice
to strive for optimal oral and overall health for the people of
Saskatchewan. Policies should ensure that every senior and long
term care resident has the right and access to oral health care
services:
2.1 An individualized oral health care plan
2.2 Basic oral hygiene supplies
2.3 Daily oral hygiene
2.3 Professional dental services
2.4 Oral health record included within the resident’s health record
2.5 Dental recommendations/orders are followed
Note: As per Section 23 of the current Personal Care Home Regulation, each resident
receive a dental examination, as necessary.
Better Oral Care in Long Term
Care

19. SOHP Goal #3
That an Oral Health Coordinator (OHC)(s), who is a licensed
oral health professional, should be employed in each health
region to facilitate the delivery of initial oral assessments,
dental examinations and treatment, daily oral hygiene for
residents and oral health education. The Oral Health
Coordinator will work collaboratively with the long term
care, multi-disciplinary team to improve the oral and overall
health of residents.
Better Oral Care in Long Term
Care

20. SOHP Goal #4
That upon entry into a Long-Term Care (LTC) home, an initial oral
assessment must be completed by a licensed oral health
professional, through the general/medical consent provided by the
long term care home.
4.1 Oral assessments should be routinely performed every 6
months thereafter, by an oral health professional or a
health care professional trained in oral health.
4.2 Non-oral health professionals performing oral health
assessments or care will receive appropriate training
developed by this project.
4.3 All training will be provided by oral health professionals.
Better Oral Care in Long Term
Care

21. SOHP Goal #5
That initial oral assessments may trigger a referral to a dentist for a full
dental examination to include:
5.1 Personal client record, including consent for dental examination
5.2 Review of medical and dental history
5.3 Complete examination of the oral cavity, to include:
5.3.1 Assessment of hard and soft tissues
5.3.2 Assessment of oral hygiene care
5.3.3 Oral cancer screening
5.3.4 Denture Assessment
5.4 Treatment plan/progress notes
5.5 Estimate/Consent for financial responsibility
5.6 Consent for treatment
Better Oral Care in Long Term
Care

22. SOHP Goal #6
Treatment needs based on the dental examination,
may be provided by dentists, denturists, dental
hygienists, dental therapists and/or dental
assistants. Residents may access dental services
through their personal oral health professional or
through dental services as available through the
long term care home.
Better Oral Care in Long Term
Care

23. SOHP Goal #7
That the Saskatchewan government
establish a safety net program for more
equitable access to oral health services
for low income residents.
Better Oral Care in Long Term
Care

24. SOHP Goal #8
That the Saskatchewan Seniors Oral Health
and Long Term Care Strategy is incorporated
into post-secondary educational health
training programs, orientation, and
continuing professional development (i.e. for
physicians, nurses, care aides, etc).
Better Oral Care in Long Term Care

25. SOHP Goal #9
That the standard for new long term care
homes includes provision for a treatment
room suitable for a variety of health
professionals including access to portable
dental equipment to facilitate dental
treatment.
Better Oral Care in Long Term
Care

26. SOHP Goal #10
That the implementation of a Saskatchewan
electronic health record includes an oral
health component.
Better Oral Care in Long Term
Care

27. SOHP Goal #11
That surveillance, evaluation and continuous
quality improvement be performed on an
ongoing basis to demonstrate improved
health and oral health status outcomes.
Better Oral Care in Long Term
Care

28. Together, making a difference
Better Oral Care in Long Term Care