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                                                        DR. DAN PETERSON

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Elderly people who live in nursing homes are at greater risk for oral health problems compared to elderly people who live independently

As people age, medical complications and other factors can negatively affect oral health. Evidence shows that older Americans are at risk for greater oral health problems than other groups because of age and the inability to get to a dentists office due to an existing medical condition or lack of transportation.

"Oral health of frail elders residing in long-term care facilities is very poor.  Most of the care at nursing homes is medical care and nursing care, and sometimes the oral health needs are overlooked.

Children or relatives should take an active role in the oral health needs of elderly people residing in nursing homes:

bulletAssisting with:
bullet brushing
bullet flossing
bullet looking around the mouth for canker sores and abscesses 
bulletAll oral health problems, should be reported to the nursing staff for proper diagnosis and treatment.

Important questions to ask nursing home administrators:
Before choosing a nursing home for an elderly person, relatives and loved ones should inquire about the quality and consistency of dental care at the facility:
bulletDoes the home have on-call dentists?
bulletIs nursing home staff trained in basic mouth care?
bulletIs the nursing home staff trained to recognize oral pathology?
bulletDoes nursing home staff emphasize mouth care at least once a day?

If the staff or home administrator can't say 'yes' to each of these questions, then these areas need to be addressed before admitting your loved one into the care facility.

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Dental Plaque And Respiratory Infection in Elderly

Dental plaque may often be home to respiratory pathogens responsible for hospital-acquired pneumonia (HAP), according to a study by researchers as the University of Buffalo in NY. Of 49 critically ill nursing home residents who required intensive care treatment, 28 or 57% had aerobic pathogens in their dental plaque, including Staphylococcus aureus, and enteric Gram-negative bacilli, pathogens commonly found in elderly patients with severe pneumonia, and 14 or 29% developed HAP. According to a report in Novemberís CHEST (Journal of the American College of Chest Physicians), institutionalized elders comprise a population that has dental plaque
due to lack of oral hygiene, among other factors.

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Plaque Can Cause Aspiration Pneumonia 

In research on a group of 95 elderly persons from nursing homes who were hospitalised for severe aspiration pneumonia, investigators concluded that the bacteriology associated with their disease could have sprung from micro-organisms that had been colonized in either their dental plaque or oropharyngeal cavity at the time of aspiration.  Many older institutionalized patients have deterioration in their activities of daily living, It is quite plausible that poor oral health, because of the difficulty of accessing professional dental care and insufficient or poor oral hygiene, leads to an environment that promotes colonization of dental plaques by anaerobic and Gram-negative organisms.
June 2003 of the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine, Ali El-Solh, M.D., M.P.H., of the Division of Pulmonary, Critical Care, and Sleep Medicine, University of Buffalo School of Medicine, Buffalo, New York

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Resource: July/August 2002 issue (Volume 50, Number 4) of General Dentistry.

Aspiration Pneumonia Linked to Poor Dental Health 

Following research on 95 elderly patients from a nursing home who were hospitalized for aspiration pneumonia, investigators concluded that the bacteriology associated with their disease could have come from microorganisms colonized in either their dental plaque or oropharyngeal cavity at the time of aspiration. Aspiration pneumonia consists of inflammation of the lung and bronchi caused by inhaling or choking on vomit.  They concluded that poor dental health in nursing home patients due to lack of professional dental care and poor oral hygiene could easily have led to an environment that promoted the colonization of dental plaque by anaerobic and Gram-negative organisms. Of the 67 pathogens identified, Gram-negative enteric bacilli comprised 49%, anaerobic bacteria comprised 16%, and Staphylococcus aureus comprised 12%. The crude mortality rate among the patients studied was 33% for the anaerobic group. The study, conducted by researchers at the University of Buffalo School of Medicine (NY, USA), was published in the June 15, 2003, issue of the American Journal of Respiratory and Critical Care Medicine. The authors noted that neither nursing home staff nor physicians appeared to give high priority to the oral care of residents. 09/03

February 06, 2008

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PLEASE NOTE: The information contained herein is intended for educational purposes only.  It is not intended and should not be construed as the delivery of dental/medical care and is not a substitute for personal hands on dental/medical attention, diagnosis or treatment.  Persons requiring diagnosis, treatment, or with specific questions are urged to contact your family dental/health care provider for appropriate care.
This site is privately and personally sponsored, funded and supported by Dr. Peterson.  We have no outside funding.
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