Quebec program aims to ensure all residents have access to dental care and treatment as needed
Since September, nurse clinician Lyne Déry has been training nursing staff in our six long-term care centres on how to maintain dental health in residents and detect potential problems that may require a referral to a dental professional.
The training is part of a new Quebec health ministry program that addresses a reality: Residents in long-term care are at higher risk of tooth decay due to their loss of autonomy.
The team is made up of three dentists, a denturologist and dental hygienist. “They have all received the government training and work closely with an interdisciplinary approach alongside the nursing teams in each of our long-term care residences,” says Ms. Déry, who has been working within our CIUSSS’s long-term care facilities for many years.
Under the program, every new resident admitted to a long-term care centre is seen by a dentist. Registered nurses are also trained to do regular evaluations of each resident’s oral health and will call for a consult with a member of the dental team as needed.
In her training, Ms. Déry says it’s important for orderlies – who help residents with their daily tasks – to recognize what’s normal in an aging mouth, versus what may be cause for concern. “Yellowing teeth, varicose veins in the lips and mouth and cracks on the tongue are all normal signs of aging,” Ms. Déry explains. “Symptoms that could signal a problem and may require a referral to a dental professional include signs of tooth decay, redness and swelling of gums, or a fungal infection.”
Ms. Déry’s training involves the use of images, as well as special tooth brushing techniques for residents with more challenging behavior. Orderlies are given access to plasticized cards which outline the dental care for each resident in their care plan.
The new dental health program also provides new oral care supplies adapted for the needs of residents in long-term care, including toothpaste that doesn’t foam so it’s safe to use for people with dysphasia or on feeding tubes.
Dentist Dr. Rachel Lin says she is noticing an improvement in the oral health of residents as the dental program is being implemented. “There’s been a dramatic difference since this program began,” she says. “I don’t need to give the residents a cleaning before I examine their mouths anymore!”
Dental hygienist Tinoosh Dibamehr says she’s particularly sensitive to the needs of residents. “We want them to be comfortable and able to eat and speak to others with confidence,” she explains. “Many of these residents haven’t been to a dentist in a long time and have trust issues. I come here when I’m not doing cleanings to talk with them and establish trust. If there are any problems, I will get a member of the nursing team to help the resident feel more comfortable.”
Banu Patel, a registered nurse at Henri Bradet Residential Centre, says working in tandem with the dental team has been a positive experience. She says the training she received to assess residents’ oral health was a good opportunity and even led to some surprises: “We didn’t even know certain residents had dentures,” she says. “One of our residents wasn’t eating but when we discovered their dentures weren’t fitting properly, we were able to solve the problem. The dental program is good for our team and good for our residents. It’s never too late to look after dental health!”