Oral Health Care: Sub-Optimal In Nursing Homes In Canada

Experienced nurses find ways of incorporating oral care into regular assessments – combining the two encourages performing the oral hygiene care and saves time. Dale, et al. (2016) quoted an un-named ICU administrator who commented, “I would hope that they are teaching (mouth care) in the critical care curriculum.” Stressing the importance of oral care early in the training of a new critical care nurse should help to solidify the inclusion of oral care into regular daily practice.

Oral health has a direct impact on the general health, hence, it is important that all Canadians have adequate access to dental care services. Over the years successive Governments have reduced financial support to programs delivering dental care to most vulnerable populations. As a result, many low income families and other vulnerable groups have been unable to access dental care. There is further escalation in the disparities in oral health care among Canadians, as the number of Canadians losing dental care benefits continues to increase. Also, higher oral health care costs can be expected in the near future due to shortage of health care professionals.

As a nurse in a skilled nursing facility, oral hygiene care is very important, but the importance significantly increases when our patients are functionally dependent or cognitively impaired. These patients are unable to perform this task and depend on nurses to provide daily care. Nurses need to pay close attention for potential problems. They will need to perform assessments, develop oral care plans, and identify preventions and strategies to eliminate any potential problems. Poor oral health has been linked to serious systemic illnesses including diabetes mellitus, stroke, hypertension, myocardial infarction and aspiration pneumonia (Dyck et al., 2012). Patients who suffer from a lack of oral care can have a dramatic impact to their

Dental hygienists examine for signs of abnormalities oral diseases, for example decay or gingivitis, then they will provide treatment if necessary. They play an important role in evaluate patients’ oral health and interpret findings for the dentists. Also, Dental Hygienists educate patients how to keep their oral healthy. It is obvious that Dental Hygienists have to work by hands all the time; therefore, they are required to keep their hand totally clean and get them sterilized before and after each patients. They have to wear protection tools including safety glasses, masks, and gloves to prevent infection for themselves and patients (Bureau of Labor

VAP is defined as a patient who is mechanically ventilated for greater than 48 hours and exhibits three out the five symptoms: fever, increase leukocytosis, change in sputum color or amount, radiographic evidence of new/progressive infiltrates and worsening oxygen requirements along with a culture identifying a bacterial microorganism (CDC, 2008). Risk factors associated with the formation of VAP is the altered oral physiology where there is a decrease in saliva production decreasing the pH level forming an ideal environment for bacteria to grow, respiratory pathogens such as Staphylococcus aureus, Streptococcus pneumonia, Methicillin Resistant Staphylococcus aureus and Pseudomonoas aeruginosa which can form a biofilm on the teeth that we know as plaque that can then aspirate and travel down to the lungs (Koeman et al., 2006). Several studies (Munro et al., 2009) have verified that removing bacteria from the oropharynx requires the removal of dental plaque, and the only way to remove the plaque is with toothbrushing. Others found that the majority of nurses use a soft Toothette instead of toothbrushing and that the Toothettes do not

Research has shown that staff training in oral hygiene and the use of an individualised Oral Hygiene Care Plan is beneficial to the resident and also the nurse and will allow appropriate care (National Guideline Clearing house [NGC], 2003).

Infection control is a central concept to every practice of health care providers. Its main objective is to prevent the transmission of infectious diseases from both patients and health personnel (Martin et al., 2010). In dental clinic, infection control is a continuous concern for its professionals. They have to contact patients routinely and be exposed to their blood, saliva, dental plaque and pus that may contain infectious pathogens. It is important for the dental professionals to treat these fluids as if they are infectious and special precautions must be taken to handle them. In this essay, I will highlight the scope of infection control practices in dental clinics and the ways through which infectious microorganisms are transmitted

Oral care aims to supply an adequate hygiene level, which leads to reduce colonisation of dental plaque and oropharynx and to reduce the aspiration of contaminated secretions into the lower airway (Feider et al. 2010). Research has demonstrated that colonisation of the airway and aspiration of colonised saliva are the two main pathogenic causes of VAP (Adib-Hajbaghery et al. 2011). Other cause is the production of a biofilm along the endotracheal tube (ETT) which contains large quantities of microbes that could be spread into the lungs by ventilator-induced breaths (Keyt et al. 2014; Palomar et al. 2010). Additionally, instilling saline into the ETT, suctioning secretions, repositioning the ETT or coughing, could dislodge the biofilm into the airway and increase the risk of VAP (Moore. 2003; Morehead and Pinto. 2002).

There are two important things to do in a dental office in order to prevent cross infection. These two forms are sterilization and disinfection. According to the CDC and the Food and Drug Administration before either of these forms can be used you have to clean the instruments. This can be done either by hand or by using an ultrasonic cleaner.

In Dr. Parson’s presentation, I learned that there are still many seniors with out dental insurance. This is sad because the population by 2030 is going to double and more will eventually need treatment done by a dentist. According to her presentation oral care is not a concern to the nursing home staff. Some families show up to brush their family members teeth. With the limited financial resources for dental care these patients have it is one of their barriers to getting treatment done if needed or even cleaning. Therefore, we as dental hygienist can help make a difference by going out to the community and offering dental care education to the nursing staff because they must first know how to take care of their oral health before taking care

As the number of older Americans continue to rise, along with dental practitioners who are entering retirement, it would benefit this under-served population for the dental profession to develop new models of mid- level care. To expand training as well as additional licensing for dental hygienists, along with more training for other health care professionals would be a great beginning towards improved access to care (Overview of oral health,

As dental hygienists, we will see a variety of patients in our dental office. Each patient will present with a unique medical history. It is essential to know how to treat our patients to the best of our ability, so that they are comfortable and cared for throughout the entire treatment process. They might have a certain disability, disorder, or disease that may alter or affect how we treat them.

The patient was keen to get her oral hygiene up to a good standard and prevent any

Regular brushing of the teeth allows removal of plaque. Today, the brush does almost everything alone. The purpose of these devices is to eliminate food residues and dental plaque in the most inaccessible areas of the mouth.

Approximately 15 million people suffer a stroke worldwide each year, of those 5 million die and another 5 million are permanently disabled Mackay et al (2004). Stroke tends to affect people over the age of 75 (Scarborough et al 2009). Since almost 70% of people over 75 retain some teeth (Todd and Laden 1998), maintaining a healthy mouth is important for elderly stroke patients. Not only does effective oral care play a central role in the prevention of infection, a healthy mouth also makes a real difference to a person’s quality of life (McGrath and Bedi 1998) and maintenance of nutritional status (Jones 1998) .For these reasons, this dissertation will examine the benefits of good oral hygiene for elderly stroke patients and nurses role in