Open wide and say 'aaah!'

Share this content:
Jill Gilbert
Jill Gilbert
As a general dentist, Kristin Outlan routinely saw dementia patients bussed in to her office from nursing homes and left for hours at a time. Not only would their behavior sometimes scare the other patients, but there were also logistical problems, like getting an agitated patient to sit for X-rays. Wondering whether they would be more cooperative in familiar surroundings, Outlan began offering in-facility dentistry at local nursing homes. Since then, she has focused on geriatric dentistry. Regarding practicing outside of the traditional dental sphere, Outlan says she works without walls or boundaries. In fact, she also works with elderly patients in private homes and those in hospice. 

More complex issues

Maintenance is the key to good oral health, and medications often complicate or exacerbate patients' oral health issues, according to Outlan. Stressing the importance of holistic oral health, she is adamant that dentists and pharmacists work together.

Among dementia patients, “the mindset they had about oral health before” usually determines how apt they are to continue good oral hygiene on their own, she says. But she adds that staffers can provide simple reminders, such as taping cues to the bathroom mirror. Patience is essential in working with combative residents. “Sometimes we just have to wait and try another day,” Outlan says.

Preventative screenings

Outlan hopes that nursing homes will begin conducting more thorough dental screenings on admission as well as periodic screenings thereafter. She says that the staff must be trained to know what to look for. Dentures, for example, can cause multiple infections, which sometimes go undetected by staff when patients can't verbalize the problem.  

After all, says Outlan, screening can prevent all kinds of issues, such as oral cancer, from developing.
“For some reason, everyone avoids looking in the mouth. They'll take them to bingo and to get their hair done, but no one checks to make sure their mouths are clean!”