Online Program

Assessing and Improving Oral Health for Older Adults Residing in Long-Term Care Facilities: A Virginia Dental Association Initiative

Monday, November 2, 2015

Lyubov Slashcheva, BA, DDS 2016, National Health Service Corps Scholar, Virginia Dental Association Long-Term Care Access to Care Work Group, Virginia Commonwealth University School of Dentistry, Richmond, VA
Julie Coe, DDS, MS, MBA, General Practice Dentistry, Virginia Commonwealth University School of Dentistryty School of Dentistry, Richmond, VA
Patricia B. Bonwell, RDH, BSDH, MSG, PhD, Lucy Corr Village Dental Clinic; Dental Hygiene Program, Virginia Commonwealth University School of Dentistry, Chesterfield, VA
Frank Iuorno, DDS, MS, Virginia Dental Association, Virginia Commonwealth University School of Dentistry, Richmond, VA
As older adults are retaining their natural dentition, oral care needs have shifted. Upon admission into long-term care (LTC) facilities, older adults present with existing oral pathology, as a result of decreased ability to access care in post-retirement years as well as decreased dexterity for adequate oral cleansing, yet the percentage of Long Term Care (LTC) residents with untreated oral needs ranges from 80% to 90%. Daily oral hygiene is important in preventing disease; however, cognitive and medical decline in older adults complicates its delivery. Funding oral care is also a barrier: Medicare and, in Virginia, Medicaid do not cover routine oral care for adults even while research supports links between oral health and cardiovascular disease, diabetes, mental health, arthritis, and pneumonia, which are all prevalent in the LTC population.

The LTC Access to Care Work Group of the Virginia Dental Association (VDA) addresses oral health disparities of LTC residents across the state, improving their needed access to oral care. Individual aims have included surveying facilities across the state regarding knowledge/utilization of patient pay adjustment provision programs, baseline oral health needs as documented in facility Minimal Data Sets (MDS), as well as piloting the integration of full-time preventive dental care providers within three LTC facilities to evaluate the efficacy of decreasing cost and morbidity associated with dental emergencies. A mini-pilot of the described intervention elucidates the value of integrating full-time oral health professionals into the LTC setting for active oral health maintenance and referral for necessary treatment to local providers.

Learning Areas:

Administer health education strategies, interventions and programs
Advocacy for health and health education
Chronic disease management and prevention
Other professions or practice related to public health
Planning of health education strategies, interventions, and programs
Program planning

Learning Objectives:
Identify indicators of oral health within Long-Term Care Facility (LTCF) federally-mandated records Describe a framework for assessing and improving oral health for LTCF-dwelling older adults Design a prevention-focused model for addressing oral health needs of older adults living in LTCFs

Keyword(s): Oral Health, Aging

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a member of the Virginia Dental Association Long Term Care Access to Care Work Group since its inception in August 2013 and have performed much of the data analysis/scholarship associated with the project. Additionally, I have pursued independent research that contributes to this Work Group's initiatives.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.