Stock Photo Elderly Teeth
Stock Photo

By Timothy Hyland

As the U.S. population ages, the country's nursing homes are starting to feel the strain—and according to one study, that strain is beginning to put seniors at increased risk of oral cancer.

In the study, published in October's issue of the Journal of Applied Gerontology, a team of researchers from six different institutions examined the myriad problems that prevent or deter caregivers working in long-term care nursing facilities (LTCNFs) from providing basic dental care.

It's a significant issue, they said, noting that of the 1.7 million adults aged 65 or older living in LTCNFs, only 17 percent receive any help with their oral health.

That lack of care puts a population already at risk for oral cancer at an even higher risk. Adults over 65 account for 60 percent of all oral cancer deaths, even though the overall cure rate for oral cancer—when caught early—stands at 80 percent. The team asserts that, with better dental care, the death rate for older adults in nursing homes could be reduced significantly.

Nursing homes, like other health care institutions, are subject to the tyranny of the urgent, wherein things that are urgent take priority over the things that are important. –Gerontology Researchers

The research team sought to understand why oral health is often neglected in long-term-care facilities. After interviewing dozens of professionals who serve in a variety of roles in these settings, the researchers arrived at a fairly clear answer: competing demands for resources and a challenging workplace environment often make oral health a "back-burner” issue.

"Overall, our findings indicate that LTCNFs, like other health care institutions, are subject to the tyranny of the urgent, wherein things that are urgent take priority over things that are important," the team wrote. "[The situation] was best expressed by one participant who was discussing the regulatory compliance and safety issues, and stated, 'it just isn’t a high priority, we have too many other things to worry about.'"

The researchers added that they found additional barriers to the delivery of dental care that make the situation even more entrenched: insurance regulations, lack of funding, and lack of knowledge about how poor dental hygiene can lead to oral cancer (and other systemic illnesses).

Going forward, the team proposed a number of possible interventions that could improve the situation: programs to better educate caregivers about oral health, a recruitment initiative to get more dental students or dentists into nursing home settings, and new screening programs that can be handled by nursing home staff.

The implementation of any or all of these new protocols could prove invaluable in reducing oral cancer rates for this population, the researchers said.

"Providing low-cost, simple interventions, such as mobile teams of dental students/dental volunteers and training for staff, can have lasting results," they wrote. "These interventions can address a crucial need in a lasting and important way, and as recent studies have indicated, oral care provided for as little as eight consecutive weeks can achieve a marked increase in oral health."

The research was conducted by Peter Maramaldi and Tamara Cadet of Simmons College; Shanna Burke of Florida International University; Mary LeCloux of West Virginia University; Erina White of Boston Children's Hospital; Taru Hannele Kinnunen of Behavioral Science Consulting, and Elsbeth Kalenderian of the Harvard School of Dental Medicine.


Author: Contributing writer Timothy Hyland has more than 20 years' experience as a writer, reporter, and editor. His work has also appeared in Fast Company, Roll Call, Philadelphia Business Journal, and The Washington Times.


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