Linking Oral Health to Long Term Care


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Linking Oral Health to Long Term Care

  1. 1. Linking Oral Health to Long Term Care Presented by Dental Directions Program Coordinators: Tami Wanless R.D.H., Med. & Marilyn Craig R.D.H.
  2. 3. Illinois State Dental Society (ISDS) <ul><li>ISDS has obtained a series of grants from: </li></ul><ul><ul><li>The Illinois Department of </li></ul></ul><ul><ul><li>Public Health (IDPH) </li></ul></ul><ul><ul><li>The grant funds educational </li></ul></ul><ul><ul><li>programs to the staff at </li></ul></ul><ul><ul><li>long-term care facilities. </li></ul></ul><ul><li>ISDS Grant from IDPH </li></ul><ul><ul><li>First 3 year grant in October 2001-2004 </li></ul></ul><ul><ul><li>Second 3 year grant October 2004-2007 </li></ul></ul><ul><ul><li>Third 3 year grant October 2007-2010 </li></ul></ul>
  3. 4. Who Manages Dental Directions <ul><li>Greg Johnson </li></ul><ul><li>Director of Professional Services (ISDS) </li></ul><ul><li>Tami Wanless, R.D.H, MEd. </li></ul><ul><li>Program Coordinator </li></ul><ul><li>Regions managed include Counties of Cook, Lake & DuPage. </li></ul><ul><li>Marilyn Craig, R.D.H. </li></ul><ul><li>Program Coordinator </li></ul><ul><li>For Downstate Regions </li></ul>
  4. 5. Where do the funds come from? <ul><li>The grant funds for the program come from the departments civil monetary penalty fund </li></ul><ul><li>The fund receives all of the fines that are levied against long term care facilities </li></ul>
  5. 6. In Compliance with Administrative Code <ul><li>All grant dollars must be used to develop programs that benefit long-term care facility residents (see handout from Joint Committee on Administrative Rules) </li></ul><ul><li>The ISDS program was the 1 st program to receive a grant from the fund </li></ul>
  6. 7. Goals of Dental Directions <ul><li>Improve the oral health of long-term care residents by educating the daily care-giver facility staff about basic information on proper daily oral health care needs. </li></ul><ul><li>Establish local oral health professionals expertise & technical assistance for LTC facilities regarding the ongoing oral health care needs of residents </li></ul>
  7. 8. Dental Directions Results & Predictions* 400* 2009-2010 350* 2008-2009 300* 2007-2008 195 2006-2007 176 2005-2006 146 2004-2005 Number of Facilities Educated Year
  8. 9. Presentations <ul><li>In cooperation with the Illinois Department of Public health, facilities can receive 1 hour of training from Dental Directions educators at no charge </li></ul><ul><li>Local dental health teams can support one or multiple facilities by providing information and/or care to staff & residents </li></ul>
  9. 10. In-service/ Educational Overview <ul><li>General information of each facility is reviewed with director of nursing for accuracy plus dental information shared </li></ul><ul><li>Pre & Post test given to minimum of 10 </li></ul><ul><li>staff members </li></ul><ul><li>Informative video discussing oral care & cancer detection </li></ul><ul><li>Samples & literature provided </li></ul>
  10. 11. Prevalent Chronic Diseases Associated with Aging <ul><li>Periodontal disease </li></ul><ul><li>Oral Cancer </li></ul><ul><li>Diabetes </li></ul>
  11. 12. Periodontal Disease An estimated 80% of American adults currently have some form of the disease <ul><ul><ul><li>Gingivitis </li></ul></ul></ul><ul><ul><ul><li>Pain Free-asymptomatic </li></ul></ul></ul><ul><ul><ul><li>Bacteria growing on teeth (plaque & tartar) cause infection </li></ul></ul></ul><ul><ul><ul><li>Gums become red, swollen and bleed easily </li></ul></ul></ul><ul><ul><ul><li>Can be reversed with daily brushing & flossing </li></ul></ul></ul><ul><ul><ul><li>Does NOT include bone loss </li></ul></ul></ul><ul><li>Periodontitis </li></ul><ul><li>Pain free -asymptomatic </li></ul><ul><li>Gums pull away from teeth and form pockets that are infected </li></ul><ul><li>Bacterial toxins and body's enzymes fighting the infection break down bone that hold teeth in place </li></ul><ul><li>Bad breath, bleeding gums, exudate, mobile teeth, loss of teeth and bone </li></ul>
  12. 13. What a facility will learn about Periodontal Disease
  13. 14. Periodontal Disease Risk Factors <ul><li>Smoking (Vasoconstrictor-masks disease) </li></ul><ul><li>Hormonal changes in women </li></ul><ul><li>Diabetes (higher risk for infection) </li></ul>
  14. 15. <ul><li>Medications (Antidepressants, heart meds) </li></ul><ul><li>Illnesses: AIDS, cancer </li></ul><ul><li>Genetic Susceptibility </li></ul><ul><li>Stress </li></ul>
  15. 16. Stain & Tartar
  16. 17. Active Periodontal Disease with bone loss
  17. 18. Treatment for Periodontal disease <ul><li>Main goal is to control the infection and remove contributing factors: </li></ul><ul><li>bacteria, plaque, smoking </li></ul><ul><li>Increase homecare: brushing, flossing antimicrobial mouth rinses, gum stimulation </li></ul><ul><li>Professional intervention- deep cleaning, root planing, periodontal debridement </li></ul><ul><li>Medications: </li></ul><ul><li>doxycycline,chlorhexidine </li></ul><ul><li>Surgery </li></ul>
  18. 19. Daily Oral Care Can Reduce Bacteria and Disease
  19. 20. Oral Cancer <ul><li>Each year in the USA about 29,000 people are diagnosed with Oral cancer </li></ul><ul><li>Approximately 7,000 deaths a year from oral cancer </li></ul><ul><li>6 th most common cancer in men and the 14 th most common in women – affects twice as many men as women </li></ul><ul><li>Can spread quickly </li></ul><ul><li>Most often occurs in people over 40 </li></ul>
  20. 23. Signs & Symptoms <ul><li>A sore, irritation </li></ul><ul><li>lump or thick patch in your mouth, lip, or throat </li></ul>
  21. 24. Oral Cancer Signs & Symptoms <ul><li>A white or red patch in your mouth </li></ul><ul><li>A feeling that something is caught in your throat </li></ul><ul><li>Difficulty chewing or swallowing </li></ul>
  22. 25. Oral Caner Signs & Symptoms <ul><li>Difficulty moving your jaw or tongue </li></ul><ul><li>Numbness in your tongue </li></ul>
  23. 27. Early Detection = better success <ul><li>An oral cancer examination can detect early signs of cancer </li></ul><ul><li>Exams are painless and quick </li></ul><ul><li>Refer to the US dept of health and human services poster provided and post so all staff can view and learn </li></ul>
  24. 28. Diabetes <ul><li>Patients with diabetes suffer from periodontal disease (PD)more than patients who do not have diabetes </li></ul><ul><li>High blood glucose increases bacterial growth, leading to PD </li></ul><ul><li>Immune system is compromised </li></ul><ul><li>Slower healing post PD treatment </li></ul>
  25. 29. Age related oral changes -Dentures <ul><li>Dentures should be left out at least 3 hours a day or over night </li></ul><ul><li>Bone reduction from trauma of denture pressure </li></ul><ul><li>Common oral lesions from dentures </li></ul>
  26. 30. Denture facts <ul><li>Proper fitting denture should never require adhesives </li></ul><ul><li>Dentures should be professionally cleaned frequently by ultrasonic procedure </li></ul><ul><li>Denture patients should see </li></ul><ul><li>a dentist once a year </li></ul>
  27. 31. Age Related Oral Changes <ul><li>Decrease in Saliva – in health a person produces 3 liters of saliva a day as you age, your saliva production gradually decreases. </li></ul><ul><li>Saliva naturally self cleanses your mouth and helps remove bacteria </li></ul>
  28. 32. Xerostomia <ul><li>Dry mouth due to lack of saliva </li></ul><ul><li>Can cause difficulties in tasting, chewing, swallowing & speaking </li></ul><ul><li>Increases your chance of developing decay </li></ul><ul><li>Can be caused by certain medications </li></ul>
  29. 33. Symptoms of Xerostomia <ul><li>Sticky dry feeling in oral cavity </li></ul><ul><li>Trouble chewing, swallowing and speaking </li></ul><ul><li>Burning feeling in mouth </li></ul><ul><li>Mouth sores </li></ul><ul><li>Sensitive teeth to temperature </li></ul>
  30. 34. Causes of Xerostomia <ul><li>Side effects of medications (400 – HBP & diabetes) </li></ul><ul><li>Diseases: Sjogrens Syndrome,HIV/AIDS & diabetes </li></ul><ul><li>Radiation: Salivary glands can be damaged if exposed </li></ul><ul><li>Chemotherapy:Drugs used to treat cancer can make saliva thicker </li></ul>
  31. 35. Treatment for Xerostomia <ul><li>Reduce all alcohol mouth rinses and replace with fluoride rinse (ACT) </li></ul><ul><li>Use saliva substitutes NOT candy! </li></ul><ul><li>Sip water frequently </li></ul><ul><li>Avoid caffeine </li></ul><ul><li>Chew sugarless gum </li></ul><ul><li>with Xylitol </li></ul>
  32. 37. Dental Directions Welcomes requests for Annual Inservices <ul><li>Feel free to contact: </li></ul><ul><li>Tami Wanless </li></ul><ul><li>847-924-4084 </li></ul><ul><li>[email_address] for </li></ul><ul><li>Chicago land </li></ul><ul><li>& Western Suburbs </li></ul>
  33. 38. Dental Directions Contact Information <ul><li>Marilyn Craig, RDH </li></ul><ul><li>217-735-3308 </li></ul><ul><li>[email_address] </li></ul><ul><li>Downstate Regions </li></ul>
  34. 39. Questions?