An individualized oral hygiene care plan should be a part of every resident’s interdisciplinary care plan, especially a resident with dementia who is losing the ability to communicate. Document the oral care provided in the chart each day on a checklist that follows the plan.

Use delivery of oral hygiene care as a frequent opportunity to examine the mouth for missing or broken teeth, fillings, and full or partial dentures; swollen, red, infected gums; cavities in the teeth; and abnormal areas in the soft tissue to catch oral cancer early.

The Omnibus Reconciliation Act of 1987 (OBRA’87) makes any nursing facility (NF) that accepts Medicare or Medicaid funds directly responsible for the dental care of each resident. OBRA’87 mandates that residents receive an annual oral exam, any necessary x-rays, and a professional cleaning by a dentist/hygienist team, as well as assistance with transportation to the dental office.

However, it is important to recognize that dental care for residents with dementia is best delivered on-site at the NF so the stress on the resident will be minimized and resident cooperation maximized. The NF should provide a treatment area with privacy (privacy screens are acceptable) to maintain confidentiality and resident dignity.