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Pros Help Nursing Home Residents Keep Smiling

Many elderly and disabled people who live in nursing homes need a lot more help taking care of their teeth.

On today's WVIK News Focus, Michelle O'Neill reports dentists and dental hygienists are well aware of the problem and are starting to find ways to solve it.
Many working adults buy dental care coverage from their employers. But at retirement, those benefits end. So adults 65 and older must pay dentists directly or buy private dental coverage.

Dave Voepel is the Executive Director of the Illinois Health Care Association. It represents companies that own more than 500 long-term care centers in the state.

He says Medicaid only pays for emergency dental care in Illinois. "That creates a problem because when preventatives aren't done, it can lead to emergencies." But finding dentists who accept Medicaid is very difficult. And IHCA has asked the state's dental society to help find dentists for every nursing home. But that effort is on hold because of the state's budget impasse.
 
Dr. Howard Cowen is a professor at the University of Iowa College of Dentistry. He's also in charge of its Geriatric Mobile Dental Unit

A converted RV designed for mobile dental care
Credit https://www.dentistry.uiowa.edu/education-extramurals-gmu / University of Iowa College of Dentistry
The University of Iowa College of Dentistry's Geriatric Mobile Dental Unit

He and his dental students use it to provide oral care for people at ten nursing homes within 40 miles of Iowa City. "Many of the residents can't make to an office. And using portable equipment, we provide comprehensive oral care in long-term facilities. We take the care to them."

But most communities don't have the benefit of being located close to a college of dentistry. In Iowa, Dr. Cowen says that's where the Lifelong Smiles Coalition comes in. "We created a curriculum called Mouth Matters. It's to teach direct care workers about oral care and enable them to become champions of mouth care in their facilities."

Exterior view of the Carl Sandburg College Annex in downtown Galesburg, IL
Credit submitted / Carl Sandburg College
The Carl Sandburg College Annex in downtown Galesburg, IL houses the school's Dental Hygiene program and clinic.

In Galesburg, residents can take advantage of a clinic run by Carl Sandburg College's Dental Hygiene program. Stacy Kosier is the Program Coordinator. "Recently, I hired a dentist who uses a mobile van to go to nursing homes. Unfortunately, a lot of what he does is extract teeth. By the time the dentist is available, it's too late to do any prevention."

Kosier's mantra for dental care in nursing homes, and in general, is prevention. For example, adults can get topical flouride treatments.

Another way to prevent tooth decay is to use products containing Xylitol. Dental Hygienist, Linda Rowe from the Quad Cities, says Xylitol gum, mints, and mouthwash help stop tooth decay. It's part of routine care for her nursing home clients.
"In the office setting, I evaluate patients who are getting older and approaching retirement and take care of any potential problems. That tooth needs some work or that filling isn't going to last. We take care of any factors so you don't need us."

For people with arthritis, Rowe recommends a kids' electric toothbrush. They have easy-to-use switches and are easier to hold. Instead of dental floss, water jet devices are much more effective.

Besides the pro-active approach, the professionals all seem to agree. Part of the solution is for Medicaid to cover dental and oral care for elderly and disabled adults.

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