Assessing and Improving Oral Health for Older Adults Residing in Long-Term Care Facilities: A Virginia Dental Association Initiative

As older adults are retaining their natural dentition, oral care needs have shifted. Upon admission into long-term care (LTC) facilities, older adults present with existing oral pathology, as a result of decreased ability to access care in post-retirement years as well as decreased dexterity for adequate oral cleansing, yet the percentage of Long Term Care (LTC) residents with untreated oral needs ranges from 80% to 90%. Daily oral hygiene is important in preventing disease; however, cognitive and medical decline in older adults complicates its delivery. Funding oral care is also a barrier: Medicare and, in Virginia, Medicaid do not cover routine oral care for adults even while research supports links between oral health and cardiovascular disease, diabetes, mental health, arthritis, and pneumonia, which are all prevalent in the LTC population.

The LTC Access to Care Work Group of the Virginia Dental Association (VDA) addresses oral health disparities of LTC residents across the state, improving their needed access to oral care. Individual aims have included surveying facilities across the state regarding knowledge/utilization of patient pay adjustment provision programs, baseline oral health needs as documented in facility Minimal Data Sets (MDS), as well as piloting the integration of full-time preventive dental care providers within three LTC facilities to evaluate the efficacy of decreasing cost and morbidity associated with dental emergencies. A mini-pilot of the described intervention elucidates the value of integrating full-time oral health professionals into the LTC setting for active oral health maintenance and referral for necessary treatment to local providers.