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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.
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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 [email protected] for Chicago land & Western Suburbs
Dental Directions Contact Information
Marilyn Craig, [email protected] Regions
Questions?