The document provides a 12-month evaluation report on the Better Oral Health in Long Term Care (BOH in LTC) program in two long-term care homes. It shows improvements in oral health assessment tool scores for lips, tongue, gums, teeth, and oral cleanliness from initial to 12-month follow-up assessments. A total of 49 staff were trained between the two homes. The report also provides data on denture usage and proportions of residents with healthy assessments in different oral areas.

1. Saskatchewan oral health Coalition
Fall 2018
Updates and 12month
Evaluation Report
Better Oral Health in
Long Term Care

2. Teaching and
implementing
BOH program into
another few new
LTC homes
&
Oral Care Kits being
put together for all
the residents
 Rosthern
 Middle lake

3. Traveled to LaRonge to introduce the BOH program to their LTC HOME
as well I trained the LaRonge Oral Health team for training the trainer!

4. Better Oral Health in Long Term Care
Class Room settings
for the Continuing
car aide courses
 Sherbrooke’s own CCA’s
course
Sherbrooke’sCCA students are placed
at Sherbrooke and Central haven
homes
 Saskatoon Business College
Urban and Rural classes
Continuing Care Aide’s Courses

5. Better Oral Health in Long Term Care
“ALL ABOUT ME”
Oral Health section added to “ALL ABOUT ME “ Document found in the LTC
resident’s charts

7. Better Oral Health in Long Term Care
NEW BOH in LTC Review and Quiz added to the Annual Review Fair
“ARF”
There is a this link for you to clink on to find the BOH quiz on the LTC Annual Review fair.
• You just have to log in and the BOH in LTC come out for you to look at what SCC has
put together for the staff
• This is how you would get there, if you started on the info-net page for our Saskatoon
Area
• On the left hand side under Featured links /Clink on the E- learning /LTC/BOH in LTC
• https://learning.saskatoonhealthregion.ca/course/view.php?id=387
Annual Review Fair for staff in LTC

8. Better Oral Health in Long Term Care
Surveys are completed each year by resident’s and families
There has never been a question about Daily Oral Care
 When they choose to fill out a survey their identity will not be known.
 Results provided back to the home so improvement plans can be
developed.
Oral health Question we have asked to be added to the questionnaire for 2020-2021
Question: I am offered and I receive the assistance I need to ensure my
daily oral care is provided each and every day
The Annual LTC Resident’s Survey

9. Better Oral Health
in Long Term Care
“Did you know?”
Articles for Seniors health
and Continuing care

10. Better Oral Health in Long Term Care
Huddle Talks
Oral Care – Responsive Behavior
Care givers are reluctant to provide oral care because of
many reasons:
❑Not enough time
❑Not the right dental supplies
❑Fear of being bitten
❑Challenging behaviors
❑Lack of confidence that oral care is being done properly
Your Home does have the right dental supplies, please make sure you know where they are stored
Oral Health & Responsive Behavior Strategies:
• Use your Gentle Persuasive Approach and Purposeful Interaction skills
• Timing of daily oral care may have to be adjusted to achieve daily care some times 2 care givers
are needed
• Develop ways to improve access to the resident’s mouth: overcoming the fear of being touched,
modeling, hand over hand, distraction, and/or alternative provider
• Be mindful of your body language – ensure it’s approachable.
• Establish effective verbal and non-verbal communication
• Treat your residents the way you would want to be treated. It’s not acceptable to skip mouth care
just because the resident does not request it.
• Take the time to figure out what is bothering the resident
Oral health is as important as skin integrity in protecting the body against infection.
When this defense barrier is broken because of poor oral health, the bacteria in
dental plaque can enter airways and the bloodstream causing:
 Pneumonia, Heart attack, Stroke, Lowered immunity, Poor diabetic control
Huddle Talk #4
For more information please contact:
Kerrie Krieg CDA – 306-655-431
Kerrie.krieg@saskhealthauthority.ca
Oral Care – Dentures
Did you know?
• Many oral health problems can occur in residents who wear dentures if Oral Care is not
done. Oral Care needs to be a priority!
• If dentures are not removed, allowing for the tissues to rest, infections such as thrush,
or denture sore mouth can develop.
Recommended Daily Denture Care:
• Brush dentures with a denture brush morning and night
• using a mild soap (suitable to use hand washing soap provided by the LTC home, Do
Not Use regular Toothpaste as it will scratch the dentures)
• Rinse dentures well under running water after cleaning them.
• Brush gums and tongue with a soft toothbrush morning and night to stimulate the oral
tissues. Cleaning dentures is not sufficient: both the dentures and the person’s mouth
must be cleaned.
• Best practice is to take dentures out of the mouth overnight, clean and soak in cold
water. If resident does not like their dentures out over night, encourage them remove
dentures for few hours during the day to rest their oral tissues.
• Disinfect dentures once a week with a disinfectant tablet (ie: Poly dent). Paying careful
attention to the kind of tablet, as partial dentures with clasps need a different kind of
disinfectant tablet.
• Offer and encourage the resident to drink water after meals, medications, other drinks
and snacks to keep the mouth clean.
• Chart and report any unusual findings in a resident’s mouth or the denture to the RN,
RPN, or LPN on shift.
Huddle Talk #2
Questions? Contact Kerrie Krieg,
LTC Oral Health Coordinator for SHA. (306) 655-4317

11. Better Oral Health in
Long Term Care
RUH -Heart and stroke and brain injury department

12. Better Oral Health in Long Term Care
Pizza was served
and they did come !!!
• During the staff’s Lunch and
Learn sessions in the Heart
& Stoke and Brain injury
Department at RUH
• I was able to provide
teaching on the Importance
of oral health. And introduce
to the staff the new dental
care products available to
them.
Lunch and Learn teaching sessions

13. Better Oral Health in Long Term Care
RUH Stroke and Brain injury department

14. Better Oral Health in Long Term Care
Oral Health In The Hospital Setting
Replacement for toothpaste when
needed :
Perivex is an alcohol free
antibacterial non- foaming gel
Mouth cleaning gel
Replaces Toothpaste for those with an
aspiration risk or if they have trouble with
rinsing and spitting
Helps lubricate the mouth
Water based - lubricant for the lips.
Used for brushing the tongue

15. Oral Health In The
Hospital Setting
*Regular toothbrush
 Soft Bristles
 Small brush head
 Wide handle has a soft
rubber on the grip
 Handle can be used as a
mouth prop used as a
bite rest for the patient.

16. Oral Health In The
Hospital Setting
*Interproximal
tufted end tooth brush
 Soft Bristles
 Very small brush
head
 Handle can be used
as a mouth prop
used as a bite rest
for the patient

17. Oral Health In The
Hospital Setting
To clean all 3 sides
of the teeth at
once by straddling
the teeth
Collis Curve toothbrush
 Brush head is
specifically designed
with curved bristles
 Available in 3 sizes

18. Better Oral Health in
Long Term Care
New Oral care product provided in all
three Saskatoon hospitals

19. BOH 12 month Evaluation Report
Better Oral Health in
Long Term Care

20. Better Oral Health in Long Term Care
BOH 12 month Evaluation Report
LTC home
Total
number
of
residents
Total number of
neighbourhoods
3 Neighbourhoods
assessed
Total
number of
residents at
(initial
assessment)
Total
number of
residents at
follow up
assessment
(6 months)
Total
number of
residents at
follow up
assessment
(12 months)
Sherbrooke
Community
Centre
263 7
 Kinsmen
Village
(Houses 1 to
7)
 Veteran's
Village
(Houses 8 to
11)
 4th Floor
148 115 93
Sunnyside
Adventist
Care Centre
104 3
 Diefenbaker
 Prairie land
 Riverview
104 62 51
Total 252 177 144

21. Better Oral Health in Long Term Care
BOH 12 month Evaluation Report
LTC Home Number of Staff Trained
Sherbrooke
Community
Centre
39
 1 Leadership Manager of Learning and Growth/ Training and development
 7 Neighbourhood Team Mangers
 9 Registered Nurses
 22 Continuing Care Aides
Sunnyside
Adventist
Care Centre
10
 1 Director of care
 1 Leadership Director of Education and Safety
 1 Resident Care Coordinator
 2 Registered Nurses
 5 Continuing Care Aides
Total 49

22. Better Oral Health in Long Term Care
BOH 12 month Evaluation Report
12.90%
4.30%
6.45%
76.34%
Either upper or lower complete denture
Complete Denture in one arch and partial
denture in the other arch
Only partial denture
No denture
Proportion of Dentate Residents Using Dentures

23. Better Oral Health in Long Term Care
BOH 12 month Evaluation Report
Proportion of Residents with OHAT Scores for Lips
BOH in LTC program had a significant impact on OHAT scores for Lips (p-value <0.001).
There were 54.99% more residents with healthy lips
in 12 month follow-up compared to the initial assessment.

24. Better Oral Health in Long Term Care
BOH 12 month Evaluation Report
Initial assessment Follow-up (12 months)
Healthy 56.25% 79.86%
Changes 43.75% 20.14%
Unhealthy 0% 0%
0%
20%
40%
60%
80%
100%
Proportion of Residents with OHAT Scores for Tongue
BOH in LTC program had a significant impact on OHAT scores for Tongue (p-value <0.001).
There were 41.97% more residents with healthy tongue in 12 month follow-up
compared to the initial assessment.

25. Better Oral Health in Long Term Care
BOH 12 month Evaluation Report
Proportion of Residents with OHAT Scores for Gums
BOH in LTC program had a significant impact on OHAT scores for Gums (p-value <0.001).
There were 34.18% more residents with healthy gums in 12 month follow-up
compared to the initial assessment.

26. Better Oral Health in Long Term Care
BOH 12 month Evaluation Report
Proportion of Residents with OHAT Scores for Natural Teeth
BOH in LTC program had a significant impact on OHAT scores for Teeth (p-value= 0.0003).
There were 70.56% more residents with healthy teeth in 12 month follow-up
compared to the initial assessment.

27. Better Oral Health in Long Term Care
BOH 12 month Evaluation Report
Initial assessment Follow-up (12 months)
Healthy 40.28% 67.36%
Changes 52.78% 31.94%
Unhealthy 6.94% 0.69%
0%
20%
40%
60%
80%
100%
Proportion of Residents with OHAT Scores for Oral Cleanliness
BOH in LTC program had a significant impact on OHAT scores for Oral Cleanliness (p-value <0.001).
There were 67.23% more residents with healthy oral hygiene in 12 month follow-up
compared to the initial assessment.

28. Better Oral Health in Long Term Care
Healthy residents
Proportion of healthy residents (OHAT measures) at Initial observation, 6 &12 month follow-up assessments
The 2 areas that dropped back in %’s at the 12 month were oral cleanliness and Gums and oral tissues

29. How are the results on the 12 month
evaluation possible?
Better Oral Health in
Long Term Care

30. Better Oral Health in Long Term Care
Oral health Presence in the home
Filthy mouths when arriving for their dental appointments

31. Better Oral Health in Long Term Care
Oral health Presence in the home
Checking dental care kits and finding this:
Having Care Aides
clean the dental care kits
Or this

32. Better Oral Health in Long Term Care
Teaching Care Aide how to place a NEW Partial denture

33. Assisting a Care Aide with placement of the electric toothbrush to
make sure the bristles are into the gum line

34. Better Oral Health in Long Term Care
Assisting with figuring out techniques that will work
2 brush technique. One to prop the mouth open the other to brush

35. Better Oral Health in Long Term Care
Moisturizing the mouth and lips with Perivex

36. Better Oral Health in Long Term Care
Showing the care aide how to do Hand Over Hand

37. Better Oral Health in
Long Term Care
For more information, visit
saskhealthauthority.ca.