case western reserve university



Case dental school studies oral care in nursing homes

CLEVELAND-The oral health of nursing home residents needs more attention. In a study from the Case Western Reserve University School of Dental Medicine, half of executive directors of nursing homes in Ohio responding to a survey on oral health care rated the oral health of their residents as poor or fair, yet more than 60 percent of the directors reported that they were satisfied with the care their residents received.

Findings from 338 responses to a 30-item survey sent to 1,018 nursing home directors are reported in the article, "Nursing Home Executive Director's Perceptions of Oral Care in Long-Term Care Facilities," published by the journal Special Care Dentistry . This was the first survey of long-term facility directors about the perceptions and value of oral health care in nursing homes.

Currently 1.6 million people reside in long-term care facilities. As baby boomers age that number should dramatically increase.

What sets baby boomers apart from their parents' generation is that they have grown old with their teeth due to healthier lifestyles, greater health awareness and education and fluoridated water.

"As this group begins to access senior living arrangements and eventually experience health decline, the impact of their frailty on oral health has the potential for an oral health epidemic," states Marsha Pyle, associate dean for academic affairs at the Case School of Dental Medicine and the study's lead author.

Pyle collaborated with T. Roma Jasinevicus, Case associate professor of dental medicine; Danny R. Sawyer, Case professor and chair of oral diagnosis and radiology; and Jason Madsen, a private practice dentist from West Richland, Wash.

The researchers recognize the complexities that nursing home residents and their staffs face in meeting all health needs, including dental care-which many times is left to the caregiver to provide for part or all of it.

They hypothesized that if the chief executive officer of a long-term facility valued oral health care, then standards for maintaining good oral health would be set for the nursing staff and patients.

The three-part survey obtained general facility information, the executive directors' perceptions and the priority set for oral health care in the third part. Among the findings reported were:

•  Approximately 88 percent of the facilities have a staff dentist that patients visit from weekly to less than bi-monthly.

•  Most patients have dental visits off-site since only 10 percent of the facilities have on-site dental equipment.

•  Daily dental care is usually assigned to nursing assistants, with the executive directors stating that they felt these individuals have enough time in their schedules to provide oral care.

•  How the staff values their teeth and oral health is reflected in the kind of care residents receive.

•  While the executive directors valued dental care and felt it was part of overall general health, if they had to prioritize, then medical care would come before dental care.

•  If the facility was non-profit, it tended to have more dental equipment onsite.

•  When time was a factor, 24 percent of the directors felt oral care was not worthwhile.

•  All directors recognized that poor dental care could lead to tooth loss, decay or other physical ailments.

"As baby boomers age with complete sets of their teeth, solving the problem of facilitating oral health in institutionalized populations will become increasingly important," the researchers said. "If something is not done, future residents in these facilities are at an increased risk of dental disease, including periodontal disease and root surface caries."


About Case Western Reserve University

Case is among the nation's leading research institutions. Founded in 1826 and shaped by the unique merger of the Case Institute of Technology and Western Reserve University, Case is distinguished by its strengths in education, research, service, and experiential learning. Located in Cleveland, Case offers nationally recognized programs in the Arts and Sciences, Dental Medicine, Engineering, Law, Management, Medicine, Nursing, and Social Work.