“I always say you can measure quality in a nursing home by looking in people’s mouths, because it’s one of the last things to be taken care of,” said Dr. Judith A. Jones, chairwoman of the department of general dentistry at Boston University. “Aides change someone’s Depends, change a catheter or turn somebody every few hours, but teeth often don’t get brushed twice a day.”

The neglect can lead to terrible pain for the residents. Worse, new studies suggest that this problem may be contributing to another: pneumonia, a leading killer of institutionalized older people.

Reference: The New York Times: In Nursing Homes, an Epidemic of Poor Dental Hygiene, Catherine Saint Louis

Dental pain is a primary precipitator of dental treatment in the elderly population. Yet the pain in an older person is likely to represent a more severe pathosis than in a younger individual… regular intraoral examinations become the most effective means for avoiding advanced dental pathoses and subsequent dental pain in the elderly.

Reference: Abstract. This is the 5th paper in the symposium, Pathogenesis and Management of Pain in the Elderly, presented on 9/25/86 during the 16th Annual Meeting of AGE in Washington, D.C. on 9/25/86.

A 2006 study of five facilities in upstate New York found only 16 percent of residents received any oral care at all. Among those who did, average tooth brushing time was 16 seconds. Supplies like toothbrushes were scarce, the report said.

Reference: The New York Times: In Nursing Homes, an Epidemic of Poor Dental Hygiene, Catherine Saint Louis

Dental pain is a primary precipitator of dental treatment in the elderly population. Yet the pain in an older person is likely to represent a more severe pathosis than in a younger individual… regular intraoral examinations become the most effective means for avoiding advanced dental pathoses and subsequent dental pain in the elderly.

Reference: Abstract. This is the 5th paper in the symposium, Pathogenesis and Management of Pain in the Elderly, presented on 9/25/86 during the 16th Annual Meeting of AGE in Washington, D.C. on 9/25/86.

However, in a separate investigation, over 70% of nursing home residents indicated that they had not seen a dentist for over 5 years and 82% of denture wearers were unable to clean their denture. Yet none received regular assistance. While the staff had a good understanding of the role of oral care in preventing dental disease, only one third had received training in oral health or instructions on how to provide oral care.

Reference: Ali A. El-Solh, Association Between Pneumonia and Oral Care in Nursing Home Residents

If you or your loved one is a nursing home resident, oral health should be a particular area of concern. Many residents arrive with poor oral health. Another issue is that residents’ teeth are often overlooked in nursing homes.

Among the duties of staff, brushing teeth may rank way down the list, even though doing so is federally mandated for those who can’t do it themselves. Activities such as feeding, dressing, bathing and other ADLs tend to take priority. As a result, daily oral care is often neglected.

Reference: The Importance of Senior Dental Care, written by Chris Hawkins