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Improving Oral Health of People with Disabilities Paul Glassman DDS, MA, MBA Professor and Director of Community Oral Health University of the Pacific School of Dentistry

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Page 1: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Improving Oral Health of People with Disabilities

Paul Glassman DDS, MA, MBA Professor and Director of Community Oral Health University of the Pacific School of Dentistry

Page 2: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Improving Oral Health of People with Disabilities

• Care delivery systems

• Caregiver training

• Training oral health professionals

Page 3: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our
Page 4: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

The Surgeon General’s Report

• “Although there have been gains in oral health status for the population as a whole, they have not been evenly distributed across subpopulations.”

• Profound health disparities exist among populations including:

– Racial and ethnic minorities

– Individuals with disabilities

– Elderly individuals

– Individuals with complicated medical and social conditions and situations

Page 5: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

California Dental Association Journal

August/September 2005

Page 6: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our
Page 7: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Oral Health Care Delivery System

Services delivered in locations where people

live, work, play, go to school, receive social services

Prevention services - Fl varnish,

sealants, medical model treatments

minor dental procedures

screening, triage,

prevention education

Dental office Hospital Safety net

clinic

Complex dental procedures

Page 8: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our
Page 9: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

The Virtual Dental Home in Action

Page 10: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

The Virtual Dental Home in Action

Page 11: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our
Page 12: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our
Page 13: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our
Page 14: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our
Page 15: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Photographs

Page 16: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Photographs

Page 17: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

The Virtual Dental Home in Action

Page 18: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

The Virtual Dental Home in Action

Page 19: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our
Page 20: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Perform Procedures in the Community

• Care management over time

• Preventive education

• Prevention procedures – Teeth cleaning

– Medical treatments

– Interim Therapeutic Restorations

Page 21: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

The Virtual Dental Home Sites

Page 22: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our
Page 23: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Radiographs

Page 24: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Radiographs

Page 25: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Radiographs

Page 26: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Radiographs

Page 27: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Photographs

Page 28: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Photographs

Page 29: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Photographs

Page 30: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Photographs

Page 31: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Photographs

Page 32: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Sealant

Page 33: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Sealant

Page 34: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Miguel and Nurse Connie

Resident in mobile chair, with oxygen

Page 35: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Interim Therapeutic Restoration

Page 36: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Interim Therapeutic Restoration

Page 37: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Interim Therapeutic Restoration

Before

After

Page 38: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Oral Health Systems for Underserved Populations

Page 39: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Caregiver Training Materials

Page 40: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

The CD (for use in a computer) contains:

• The Direct Caregiver Workbook

• The Daily Mouth Care planning and tracking form

• The Administrators and Trainers Manual

• Pre and Post-Tests

• A presentation that covers the concepts in the Direct Caregiver Workbook with a presentation script

• The Direct Caregiver Video formatted for playback on a computer

• The MDS Oral Health Assessment Video for nursing staff working in health licensed facilities formatted for playback on a computer

The DVD (for use in a DVD player) contains: • The Direct Caregiver Video with three choices: • Part I - the Direct Caregiver Workbook chapters 1-6 • Part II - the Direct Caregiver Workbook chapters 7-13 • The entire Video - Direct Caregiver Workbook chapters 1-13

• The MDS Oral Health Assessment Video for nursing staff

Page 41: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our
Page 42: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our
Page 43: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our
Page 44: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our
Page 45: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

WHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our body. As Surgeon General C. Everett Koop said “you can’t be healthy without good oral health.” When residents in a residential or long-term care facility have oral health problems, it can lead to significant health problems with widespread consequences. We know that many general health problems are related to poor oral health. Infections that start with the teeth and gums can spread, complicating: • Heart problems • Stroke • Diabetes • Pneumonia In addition, missing teeth, mouth pain and dental infections can cause: • Weight loss • Increased acting out behaviors • Reduced cognitive abilities • Reduced participation in activities All these problems can make the job of caregivers much more difficult, produce tragic health outcomes, and waste valuable organizational resources.

HOW CAN IMPROVED ORAL HEALTH BENEFIT EVERYONE? • Reduced mouth odors, making it more pleasant to be with the person • Reduced acting out behaviors, making it easier to work with the person • Residents who are more interactive with others in the facility • People eating without mouth pain and requiring less care • Pride among the direct care staff at seeing the residents they care for become healthier with a happier smile • More efficient use of organizational resources

Page 46: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our
Page 47: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Overcoming Obstacles Program • Collaborators

– Pacific School of Dentistry

– Apple Tree Dental

– California Dental Association

– California Dental Hygiene Association

– American Dental Association Elder Care Committees

– California Association of Health Facilities

– American Health Care Association

Page 48: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our
Page 49: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our
Page 50: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

On-Line Training for Oral Health Professionals

Page 51: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

On-Line Training for Oral Health Professionals

Page 52: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

On-Line Training for Oral Health Professionals

Page 53: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

On-Line Training for Oral Health Professionals

Page 54: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

On-Line Training for Oral Health Professionals

Page 55: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our
Page 56: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our
Page 57: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our
Page 58: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our
Page 59: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

On-Line Training for Oral Health Professionals

Page 60: Improving Oral Health of People with Disabilities Health for People with Disabilities (updated).pdfWHY IS ORAL HEALTH ESSENTIAL? The mouth is one of the most important parts of our

Improving Oral Health of People with Disabilities

Training of

Oral Health

Professionals

Delivery

Systems

Training of

Caregivers