FREQUENTLY ASKED QUESTIONS

Oral care is on the list of Activities of Daily Living (ADL’s) that nursing assistants are to assist residents with. However, oral care is one of the most frequently neglected tasks. A 2006 study showed that 18% of nursing home residents receive 16 seconds of tooth brushing from a nursing assistant daily. This is the best it gets. There is good reason for this. Nursing assistants are busy taking care of things other than oral care. When they don’t have time to complete everything, oral care is easily left undone. No one can really tell if it has been completed and often times the mouth goes unchecked by supervisors. Nursing assistants also have limited education on how to deliver effective oral care, which leads to them not wanting to brush and floss residents teeth. Nursing assistants also get bitten by residents when they attempt to brush and floss their teeth. This also makes the nursing assistant hesitant to deliver oral care.

In the majority of situations, they don’t. This contributes to why the nursing home population has extensive oral disease, poor oral hygiene, and suffer the worst oral health of any population.

While nursing homes are supposed to have a dentist affiliated with the facility, they often are there only to provide dental exams, which is mandated by laws. In many states, each resident is supposed to have an exam by a dentist at least annually. Most nursing homes do not have a dentist on staff who is actually providing dental services.

No. Dental hygienists are not routinely employed by nursing homes. Some homes do have hygienists that work in the facility, but this is the exception rather than the rule.

No. Cleanings once or twice year is not enough to control the potential destruction of the teeth and gums and systemic conditions that may result from, or be worsened from, inadequate daily home care.

Imagine if you could not adequately brush and clean between your teeth on a regular basis and you didn’t have anyone who could help you who knew how to do these tasks well. Do you think that one or two cleanings per year would keep your mouth feeling fresh and healthy? Plaque that is not removed regularly sticks to the teeth and forms biofilms. These biofilms cause destruction and trigger the body’s inflammatory response. Inadequate brushing and in between the teeth cleaning can result in gingivitis in a matter of days. Without proper intervention the gingivitis (inflammation of the tissues) can quickly turn into periodontal disease (destruction of the bone holding in the teeth). Inflammation in the mouth can travel throughout the body causing inflammation/infection elsewhere.

It is still important to see the dental team twice a year for adequate removal of any tartar (calculus), examination of the soft tissues in the mouth, assessment of the gums and bone levels, oral cancer screenings, any necessary radiographs, and cavity detection. The goal of our Oral Care Specialists is to keep elders mouths healthy to make appointments with the dental team easier, more comfortable, and less costly.

Medicare doesn’t cover routine dental care or dental procedures, like cleanings, fillings, tooth extractions, dentures, dental plates, or other dental devices.

This varies from state to state. While some states do cover some dental services, most dentists do not accept Medicaid for payment.

These services typically need to be paid for by the resident or their families. Which is a reason many residents go without dental/dental hygiene services. This contributes to why the nursing home population has extensive oral disease, poor oral hygiene, and suffer the worst oral health of any population.

Poor oral hygiene can result in oral disease. Oral disease has the potential to create other health problems, including aspiration pneumonia, increased risk for heart disease, and stroke which can all lead to death. Residents with poor oral health are more likely to develop diabetes than those with good oral health and those with diabetes are more likely to develop periodontal (gum) disease. Dependent elders have many health challenges. Keeping their mouths healthy can keep some of these challenges at bay. As the saying goes, an ounce of prevention is worth a pound of cure!

Practice good oral hygiene measures, including brushing, cleaning between the teeth three times a day, and limit the amount of sugared foods they consume. The goal is to keep the bacteria in the mouth to a minimum. Brushing and cleaning between the teeth help remove bacteria from the oral cavity. Sugar feeds the bacteria in the mouth which allows them to create plaque. Plaque causes tooth decay and gum disease. Limiting the amount of sugar that is eaten helps keep the bacteria from creating the acid that causes problems.

HyLife connects nursing home residents with an Oral Care Specialist who visits the resident once a week for approximately 15 minutes. During this visit, the Oral Care Specialist thoroughly brushes and cleans between the residents teeth. They also check the oral cavity for anything that looks unhealthy. If they notice something that may be of concern, they alert the care team of this situation, so that a dentist can be contacted by the nursing home and the dentist can assess the situation. This reduces residents having advanced disease before a potential problem is recognized by the nursing home care team.
HyLife also provides the resident with xylitol gum/mints, xylitol toothpaste and toothbrush for daily use. Xylitol helps in the reduction of bacteria causing plaque in the mouth. Using xylitol daily in the form of gum/mints and toothpaste helps control plaque build-up between visits from the Oral Care Specialist.

Any dependent elder who has difficulty maintaining their own oral health, providing HyLife has an Oral Care Specialist available in their geographical area.

These services are paid for by the resident, their families, or from funds set aside for nursing home residents to receive special services.

Cost of services vary by location. Fees cover 4 monthly visits by the Oral Care Specialist, 180 xylitol sweetened mints each month, tube of xylitol toothpaste each month, and new toothbrush quarterly. Please contact Hylife for pricing in your area.

Yes. While the Oral Care Specialists are registered dental hygienists,(because they are the people best suited to perform oral care services) they also hold a Care Giver Certification through the American Caregivers Association.  Brushing and cleaning between the teeth with over the counter items, such as dental floss, is a task that is delegated to care givers of dependent elders. While performing oral care services, the Oral Care Specialists are operating under their Care Giver Certificate and are not performing dental hygiene services.