Cindy Luxem, president and CEO of the Kansas Health Care Association (KHCA), is making dental hygiene assessment a priority and working on a program to improve oral health care in Kansas facilities.

KHCA received a grant to develop a program in which caregivers, working in conjunction with a dental hygienist, provide oral health care daily for residents of the state’s LTC facilities. “In Kansas, we have the ability for a dental hygienist to work in long term care facilities if they have special training,” says Luxem.

“We teach CNAs and nursing staff and anyone with resident contact on how to identify [dental] problems and encourage daily hygiene.”

The program starts with providing a denture identification kit so dentures don’t get lost or mixed up, training in the use of an ultrasonic machine to clean dentures and partials, and six hours of training in the recognition of chronic health conditions that might affect residents’ ability to care for themselves. Staff are also trained in how to approach residents when it’s time to conduct an initial assessment of the resident’s oral health status.

Training then focuses on how to conduct a thorough oral health status assessment, with one staff member doing the charting while another is examining the resident’s teeth, gums, and mouth in general. More training is provided on how to develop an oral health care plan for each resident based on the findings of the assessment.

Once all the training is complete, residents and family members or other representatives are educated on the new oral health program.

Not only is it something that tends to please residents and families, family members of residents with cognitive issues can often offer suggestions as to what the resident’s desires are surrounding oral health care, such as when they used to like to brush their teeth. That way, the care plan can be tailored to each resident’s preferences, preserving dignity and choice.

Program Yields Improvements
The program has shown over its three years that residents’ overall health and well-being are improved. Unexpected benefits have also appeared. “We had a resident who was combative at the table,” Luxem told an AHCA meeting to discuss oral health care. She would actually strike out at staff trying to help her, but when her mouth was assessed, staff found she had six teeth broken at the gum line. After she received treatment for these teeth, her behavior improved so dramatically that she was taken off behavior medications.

Another unexpected benefit has been that the nursing facilities’ expenditures have decreased. Staff were finding problems earlier—before they grew into large problems requiring excessive staff time to manage, and preventing other problems from ever developing.

The program has also caused residents to become more proactive about their own dental health, going to staff when they have a problem with their daily hygiene or with symptoms of dental problems such as pain or swelling.

Facilities participating in the program also found that it was a selling point; it’s a program that their competitors don’t have.​