Malnutrition can have many causes, but one of the most frequently overlooked causes is mouth, tooth, and/or gum pain. When a resident has pain that makes it difficult to chew foods, the resident may choose to not consume enough nutritious food to stay healthy, rather than subject him or herself to mouth pain. Over time, the resident then becomes malnourished, usually leading to severe consequences. However, dental problems can be prevented, or avoided altogether, if the nursing staff monitors the resident’s dental health, and provides the appropriate oral care to the resident as necessary.
The National Institute of Dental and Craniofacial Research estimates that, of the senior citizens 65 years or older living in the United States, 92% have had some sort of dental decay or cavities in their permanent adult teeth, and 23% have presently untreated tooth decay. Furthermore, approximately 5% of the senior population over 65 have no teeth whatsoever. Dental problems are some of the most frequently overlooked health issues faced by residents in nursing homes, yet rarely do they receive treatment in a timely manner.
In addition to tooth decay, older individuals often face many potential dental dangers, including dry mouth, which can actually promote tooth decay, oral cancer, and complications due to dentures and/or dental implants. Not maintaining a healthy, clean mouth can exacerbate these problems and can encourage gingivitis (gum inflammation), which can lead to the development of periodontitis (gum disease). Dental health is so important to preventing other serious problems that it is specifically provided for by federal law in the Omnibus Budget Reconciliation Act of 1987.
The Omnibus Budget Reconciliation Act of 1987 Dental Provisions
The Act requires that nursing homes and long-term care facilities that participate in the Medicare & Medicaid reimbursement program provide each and every resident with a comprehensive oral health assessment upon admission to the facility, as well as once a year thereafter. From this annual assessment, an individualized oral health plan is crafted for each resident. The federal law also provides that nursing home residents shall receive assistance with scheduling and obtaining both routine and emergency dental services. This includes taking prompt action when a resident has lost or damaged his or her dentures, which require immediate replacement. Dental treatment is to be provided to residents by nursing staff dentists or dentists contracted by the facility to provide such care for residents. Furthermore, if a resident requires assistance with the act of brushing his or her teeth, nursing staff must provide such assistance.
When a resident arrives at the nursing home with poor dental hygiene or in poor dental health, the nursing home is tasked with providing the required care. Similarly, staff is responsible for making sure residents are practicing good dental hygiene. This can be challenging for nursing staff to enforce since residents can misrepresent whether they have brushed their teeth properly. However, regular visual inspection of residents’ teeth should be helpful at identifying problems early.
If you believe your elderly loved one is suffering from malnutrition caused by neglect or the direct actions of the staff at the nursing home, or if you are concerned about the dental care your loved one receives in the home, please do not hesitate to contact the Rooth Law Firm online or by phone at (800) 598-4348.
American Dental Association, Nursing Home Care (Geriatrics)
Albert H. Guay MDM, The Oral Health Status of Nursing Home Residents: What Do We Need to Know?, 2005, American Dental Education Association, Journal of Dental Education, Summit Proceedings