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Are my parent's dental needs met in a nursing home?

Every nursing home is different when it comes to oral care. That's why it's important for you to do a little research when it comes to selecting a nursing home for you or someone you love. For instance, some nursing homes schedule dentists and dental teams to come and provide care on the premises. In other cases, you may need to arrange visits yourself or may need to drive your loved one to the office. The most important thing to keep in mind as we get older is that good dental care still matters. 

Many nursing home residents do have their dental needs met, however, many do not. The only way to find out is to make sure that your parent sees the dentist on a regular basis. 

Every skilled nursing home is required to have a care plan for oral care. As your parents decline cognitively and physically, their care plan at the nursing home should be modified to accommodate these changes. This is usually completed by a nurse who may not have adequately assessed your parent's abilities or changed the care plan as your parents have declined. Ask for a copy of the care plan and take it to the dentist appointment to have the dental professional determine if the care plan is appropriate. In addition, if your parents are at risk for tooth decay, ask the dentist or the physician to write a prescription for an antimicrobial rinse called Chlorhexidine for the nursing staff to brush the teeth with. This will reduce the bacterial load in the mouth and requires the nurse to sign off that it has been performed. Daily fluoride prescriptions are less effective in nursing homes because the fluoride cannot penetrate through plaque and food debris that is often not removed before the fluoride is applied. Instead, I would recommend for your parents to see the dentist more frequently for cleanings and fluoride applications performed by the dental hygienist to ensure the fluoride is effective.
Rita Medwid
Dentist

More than likely, your parent's are not having their teeth brushed and flossed on a daily basis. Teeth are not considered a priority, when other health issues are in high demand. Some nursing homes are fortunate to have a mobile dentist that visits the facility. See if you can take your parent to a dentist, or have one visit them at the residence. Many nursing home patients are on anti-depressants and other medications that dry out their mouth. You can help by checking with the medical doctor to see if they are on the right drugs. You can help by giving your parent some sugar-free candies and gum that are sweetened with Xylitol, a natural sugar that decreases the bacteria in the mouth. Check with the nursing staff to be sure what you give them is OK. Ask that your parent take out their denture or partial at night to allow the gum tissue to breathe and heal. Make sure those are labeled with their name so not to lose them.

Ms. Kathryne A. LeMieux
Neonatal-Perinatal Medicine
Supervision of your parent's care can not be emphasized enough! Patients in any environment must be proactive, have a questioning attitude, and demand expert answers to concerns and questions. Nursing home residents often are unable to advocate for their own best care. I encourage my own parents (in their late 70's and independent), to ask their provider lots of questions including why they are continuing on certain medications. They don't want the doctor to feel disrespected or infer they don't trust them, and strongly feel they must follow "orders" or suffer the consequences of a spoiled relationship with their health care provider. This is typical of elders and doesn't take into account Alzheimer's or common mentation changes in the elderly. Be an advocate for them! Check their toenails while you're at it! Condition of toenails can tell you a lot about your family and friend's care while in a nursing unit or assisted living home. 
Kynthia James
Critical Care Nursing
When your parent is in the nursing home it is important that all medical needs are met including dental. There may not be dental services on site but there are transportation services that are available to transport the residents to dental appointments so that they can get the dental care that is needed. It is important that you advocate for these services for your family.
Carol Jahn
Dentist
Oral care, sadly, is often one of the last met needs in a nursing home situation. If the resident can make a car trip from the facility, it might be best to try and coordinate a visit with a dental practice. Depending upon the laws in the state you live in, there are some mobile dental and dental hygiene vans that come on site and provide care. There are only a few dentists who specialize in geriatrics. The number is growing but there is still a long way to go. As a caregiver, you will need to be the advocate. Don't be afraid to ask your own dentist and hygienist for help - they can be one of your best allies and resources in helping you in this situation.

Nursing homes and assisted living facilities may or may not have some sort of oral health programs. Ask your parent's care facility what oral health care they offer, you may need to help your mother get the dental health care she needs and deserves. Poor oral health has been reported for elderly patients in nursing homes and assisted living facilities across the nation and world.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.