linking oral health to long term care

Linking Oral Health to

Long Term Care

Presented by Dental DirectionsProgram Coordinators:Tami Wanless R.D.H., Med. & Marilyn Craig R.D.H.

Illinois State Dental Society (ISDS)

ISDS has obtained a series of grants from: The Illinois Department of Public Health (IDPH) The grant funds educational programs to the staff at long-term care facilities.

ISDS Grant from IDPH First 3 year grant in October 2001-2004 Second 3 year grant October 2004-2007 Third 3 year grant October 2007-2010

Who Manages Dental Directions

Greg Johnson Director of Professional Services (ISDS)

Tami Wanless, R.D.H, MEd. Program Coordinator Regions managed include Counties of Cook, Lake & DuPage.

Marilyn Craig, R.D.H. Program Coordinator For Downstate Regions

Where do the funds come from?

The grant funds for the program come from the departments civil monetary penalty fund

The fund receives all of the fines that are levied against long term care facilities

In Compliance with Administrative Code

All grant dollars must be used to develop programs that benefit long-term care facility residents (see handout from Joint Committee on Administrative Rules)

The ISDS program was the 1st program to receive a grant from the fund

Goals of Dental DirectionsImprove 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.

Establish local oral health professionals expertise & technical assistance for LTC facilities regarding the ongoing oral health care needs of residents

Dental Directions Results & Predictions*

Year Number of Facilities Educated

2004-2005 146

2005-2006 176

2006-2007 195

2007-2008 300*

2008-2009 350*

2009-2010 400*

PresentationsIn cooperation with the Illinois Department of Public health, facilities can receive 1 hour of training from Dental Directions educators at no chargeLocal dental health teams can support one or multiple facilities by providing information and/or care to staff & residents

In-service/ Educational Overview

General information of each facility is reviewed with director of nursing for accuracy plus dental information shared Pre & Post test given to minimum of 10

staff members Informative video discussing oral care & cancer detectionSamples & literature provided

Prevalent Chronic Diseases Associated with

Aging

Periodontal diseaseOral CancerDiabetes

Periodontal Disease

An estimated 80% of American adults currently have some form of the disease

Gingivitis Pain Free-

asymptomatic Bacteria growing on

teeth (plaque & tartar) cause infection

Gums become red, swollen and bleed easily

Can be reversed with daily brushing & flossing

Does NOT include bone loss

PeriodontitisPain free -asymptomaticGums pull away from teeth and form pockets that are infectedBacterial toxins and body's enzymes fighting the infection break down bone that hold teeth in placeBad breath, bleeding gums, exudate, mobile teeth, loss of teeth and bone

What a facility will learn about Periodontal Disease

Periodontal Disease Risk Factors

Smoking (Vasoconstrictor-masks disease)

Hormonal changes in women

Diabetes (higher risk for infection)

Medications (Antidepressants, heart meds)

Illnesses: AIDS, cancerGenetic SusceptibilityStress

Stain & Tartar

Active Periodontal Disease with bone loss

Treatment for Periodontal disease

Main goal is to control the infection and remove contributing factors:

bacteria, plaque, smokingIncrease homecare: brushing, flossing antimicrobial mouth rinses, gum stimulationProfessional intervention- deep cleaning, root planing, periodontal debridementMedications:

doxycycline,chlorhexidine Surgery

Daily Oral Care Can Reduce Bacteria and

Disease

Oral Cancer

Each year in the USA about 29,000 people are diagnosed with Oral cancerApproximately 7,000 deaths a year from oral cancer6th most common cancer in men and the 14th most common in women – affects twice as many men as womenCan spread quicklyMost often occurs in people over 40

10

Tobacco and

Cancer

What is oral cancer?

Oral cancer can affect the lips, tongue, mouth and throat.

There are two kinds:1. Oropharyngeal cancer develops in the

part of the throat just behind the mouth, which is call the oropharynx.

2. Oral cavity cancer starts in the mouth.

12

Tobacco and

Cancer

Who is at risk for oral cancers?90% of patients with oral cancers use tobacco.

75-80% of patients with oral cancers drink alcohol frequently.

More than 30% of patients with lip cancers have outdoor jobs associated with prolonged exposure to sunlight.

Other factors:

• A diet that is low in Vitamin A has been linked to oral cancers.

• Human papillomavirus (HPV) may contribute to 20% of oral cancers.

Signs & Symptoms

A sore, irritation lump or thick patch in your mouth, lip, or throat

Oral Cancer Signs & Symptoms

A white or red patch in your mouth A feeling that something is caught in your throatDifficulty chewing or swallowing

Oral Caner Signs & Symptoms

Difficulty moving your jaw or tongue

Numbness in your tongue

Early Detection = better success

An oral cancer examination can detect early signs of cancerExams are painless and quickRefer to the US dept of health and human services poster provided and post so all staff can view and learn

Diabetes

Patients with diabetes suffer from periodontal disease (PD)more than patients who do not have diabetesHigh blood glucose increases bacterial growth, leading to PDImmune system is compromised Slower healing post PD treatment

Age related oral changes -Dentures

Dentures should be left out at least 3 hours a day or over nightBone reduction from trauma of denture pressureCommon oral lesions from dentures

Denture facts

Proper fitting denture should never require adhesivesDentures should be professionally cleaned frequently by ultrasonic procedureDenture patients should see

a dentist once a year

Age Related Oral Changes

Decrease in Saliva – in health a person produces 3 liters of saliva a day as you age, your saliva production gradually decreases.Saliva naturally self cleanses your mouth and helps remove bacteria

Xerostomia

Dry mouth due to lack of salivaCan cause difficulties in tasting, chewing, swallowing & speakingIncreases your chance of developing decayCan be caused by certain medications

Symptoms of Xerostomia

Sticky dry feeling in oral cavityTrouble chewing, swallowing and speakingBurning feeling in mouthMouth soresSensitive teeth to temperature

Causes of Xerostomia

Side effects of medications(400 – HBP & diabetes)

Diseases: Sjogrens Syndrome,HIV/AIDS & diabetesRadiation: Salivary glands can be damaged if exposed Chemotherapy:Drugs used to treat cancer can make saliva thicker

Treatment for Xerostomia

Reduce all alcohol mouth rinses and replace with fluoride rinse (ACT)Use saliva substitutes NOT candy!Sip water frequentlyAvoid caffeineChew sugarless gum with Xylitol

Dental Directions Welcomes requests for

Annual Inservices

Feel free to contact:Tami Wanless847-924-4084Tamiqt314@aol.com for Chicago land & Western Suburbs

Dental Directions Contact Information

Marilyn Craig, RDH217-735-3308Macjag@cconline.comDownstate Regions

Questions?