ORAL HEALTH PROMOTION IN AGED CARE FACILITIES
LITHGOW, NSW
BAKER, Elizabeth & LI, Sabrina S.V
The University of Sydney, Bachelor Of Oral Health 2014, Oral Health in Society
RESULTS
INTRODUCTION
The Australian population is ageing; more people over
the age of 65 years require dental care because they
have retained some if not all of their natural teeth. We
are now faced with a unique opportunity for oral health
promotion in this niche demographic. Older people
living in residential care were the target group of this
project. Good general health is directly related to good
oral health. Healthy ageing is particularly reliant on a
good quality of life. Being able to speak, smile and eat
without discomfort from poor oral health is the
cornerstone of ageing well. There are several issues at
work when considering the dental management of older
Australians, even more so when they reside in rural
communities. Lithgow sits at the foothills west of the
Blue Mountains, west of Sydney. The community runs
mainly on industry and tourism. Becoming fluoridated
in 2011, oral health is a hot topic in the area. Three of
the largest aged care facilities in the Lithgow area were
contacted and they were more than happy to have oral
health promotion and education conducted with
residents and nursing staff.
FIGURE 1 - COMMON ORAL HYGIENE CARE PROBLEMS IN RESIDENTS
FIGURE 2 - PRE-WORKSHOP EVALUATION
(NURSES’ PRIOR KNOWLEDGE AND ORAL HEALTH CARE
PRACTICES TO AGED CARE RESIDENTS)
FACED BY NURSES IN AGED CARE FACILITIES ACROSS LITHGOW
HALITOSIS
5%
120%
CLEANING DENTURES
16%
BLEEDING GUMS
11%
100%
80%
Yes
PATIENTS UNABLE TO SPIT
5%
60%
No
40%
20%
REMOVAL OF DENTURES
19%
0%
BITING UPON BRUSHING
20%
LOOSE DENTURES
24%
FIGURE 3 - PRE- AND POST- WORKSHOP CONFIDENCE LEVELS OF NURSES IN PROVIDING EFFECTIVE ORAL
CARE TO AGED CARE RESIDENTS
VERY CONFIDENT
3
3
4
5
7
8
9
9
10
10
12
12
12
CONFIDENT
12
UNCERTAIN
METHODS
An initial needs analysis of the oral health status of
the residents of the aged care facilities in Lithgow was
carried out in April 2014. The three aged care facilities:
Tanderra Nursing Home; Cooinda Nursing Home and
Three Tree Lodge were visited over a two week period.
Interview and questionnaires were conducted in order
to determine the oral health requirements of these
facilities and if there were any areas where knowledge
and understanding was lacking. The needs analysis
resulted in the production of an hour long information
session and practical workshop conducted with the
nursing staff at the three facilities. Both pre and post
questionnaires were completed by the participants of
the workshop. 33 initial needs analysis questionnaires
were completed by both nurses and management staff
of Three Tree Lodge, Cooinda and Tanderra Nursing
Homes. 12 members of the nursing staff attended the
presentations.
R E C O G N I S I N G C O MMO N O R A L H E A L T H
P R O B L E MS
POST-W ORKSHOP
P R E - W OR K S H O P
POST-W ORKSHOP
USING CORRECT TOOTHBRUSHING TECHNIQUE/S USING CORRECT TOOTHBRUSHING TECHNIQUE/S
IN RESIDENTS
IN DIFFICULT RESIDENTS
DISCUSSION
Post questionnaires revealed an 80% increase in confidence in identifying
and using different dentifrices and methods to treat common oral
conditions of elderly patients. At the same time there was an initial 25%
decrease in confidence in providing good oral hygiene to residents as
nurses came to recognise through the delivery of our programme that their
previous methods were incorrect (particularly in regards to tooth brushing
and denture care). After specific issues were discussed, the nursing staff
felt much more confident in using the new oral care techniques we
demonstrated to them. The practical session of the workshop also assisted
in putting theoretical techniques we had discussed into practice. Staff were
surprised by the effectiveness of new techniques and were excited to use
them in daily oral hygiene routines.
Our programme highlighted that there are several confounding factors at
work in these aged care facilities, including time constraints and lack of
staff training. These constraints can easily be overcome however, through
education and training as well as ongoing support from allied health
professionals in the rural community. Developing a team approach and
assigning staff members as “champions” for oral health may help with high
staff turnover rates and assist in making daily oral health a priority.
AKNOWLEDGEMENTS
The University of Sydney, Dr Aravinthan S. Bharathy, Kylie Amos, Staff of
the Lithgow Community Oral Health Centre, Sue Lenon, Tanderra
Nursing Home, Cooinda Nursing Home, Elizabeth Manager and staff of
Three Tree Lodge, NSW Department of Health, COHS NSW, Colgate.
P R E - W OR K S H O P
PROVIDING EFFECTIVE DENTURE CARE
0
POST-W ORKSHOP
0
P R E - W OR K S H O P
0
1
0
0
0
0
0
P R E - W OR K S H O P
0
POST-W ORKSHOP
0
P R E - W OR K S H O P
0
0
0
The aim of this project was to assess the oral health
needs of the three major aged care facilities in the
Lithgow area of NSW. Elderly people in rural
communities represent a population at high risk of
poor oral health and one which would benefit from
assistance in this area. No oral health promotion or
education programmes had ever been conducted in
this area with the aged care demographic. This initial
needs assessment should lead to the production of an
oral health promotion programme. Any programme
developed in the future should target these particular
needs so it can be re-implemented and continued in
years to come.
1
2
AIM / HYPOTHESIS
POST-W ORKSHOP
R E C O G N I S I N G & T R E A T I N G D R Y MO U T H
CONCLUSION
Further work in this area, using our needs analysis as a starting point, needs
to be accomplished in order to make an effective oral health promotion
package which can be evaluated and re-implemented.
The information that was provided by our needs analysis and programme
was well received both by management and staff at the aged care facilities.
They are all more than happy for further work to be done in the future.
Lithgow in the Blue Mountains area of New South Wales provides a
wonderful starting point for an effective and very successful oral health
promotion programme to be implemented.
Since there has been no oral health promotion conducted previously the
area is a clean slate of very willing and capable nursing staff and
management staff, eager to implement and reinforce good oral hygiene
messages for the older high care patients of residential care facilities.
REFERENCES
Fricker A. Lewis A. 2009, Better oral health in residential care final report.
Central Northern Adelaide Health Service - South Australian Dental Service.
Chalmers J. M. et al 2009, Caring for oral health in Australian residential
care. Dental Statistics and Research Series. Canberra, ACT: Australian
Institute of Health and Welfare.
Healthy Mouths Healthy Lives, Australia's National Oral Health Plan 20042013. The National Advisory Committee on Oral Health.