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Barriers To Providing Adequate Oral Healthcare In The Residential Care Setting

1014 words - 5 pages

It is well known that oral healthcare in nursing homes is substandard(1). There are several reasons that this is the case. From the dentists’ standpoint, the nursing home setting is not conducive for a proper oral examination and treatment. Many dentists cite a lack of portable dental equipment that can be taken into the residential facilities(2). As a consequence, many dentists who are willing to invest in the oral health of these residents would like for the patients to come to the office so that proper standard of care can be provided. However, nursing staff members and administrators find that the practicality of transporting residents from the nursing home to the dental office for ...view middle of the document...

The study goes on to suggest that the main reason nurses considered oral health practices unpleasant is because of the unwillingness of cognitively impaired residents to cooperate(5). To further complicate matters, 84% of the nurses surveyed felt that they would have to use “mild physical force” in order to effectively complete the daily oral healthcare procedures(5).
Another disparity when it comes to oral healthcare in the residential care setting is the level of training nurses and caregivers have toward identifying potential oral disease(2). The traditional dental examination given by a licensed dentist incorporates the use of visual and tactile elements in order to identify oral disease(2). This necessitates the use of an intraoral light, an explorer, a mouth mirror, a tongue depressor, mouth gauze, and a trained eye(2). Hard and soft tissues are examined for oral pathology. According to Chalmers and Pearson, there is currently no standard that can be used by non-dental professionals in order to help identify oral pathology in resident care facilities(2). This makes it extremely hard for those nurses/caregivers to know what to look for in certain categories of patients in these facilities. There are several of these assessments used by nurses in intensive care units, chemotherapy units, and those patients who are intubated in a hospital setting(2). They include Oral Assessment Guide (OAG), the THROAT assessment, and the Revised Oral Assessment Guide (ROAG)(2). These assessments are great because they use lay dental terms that nurses and non dental professionals can understand, are quick and computerized, require a minimum of dental examination equipment, and provide a list of potential oral pathologies likely associated with each specific group of patients (xerostomia, aspiration pneumonia, mucositis, candiasis, etc.)(2) However, as Chalmers and Pearson point out, there is currently no national standard assessment that has been developed for use in the residential care facility(2). The authors cite three potentially useful oral health assessments...

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