The Women's Journal

Who Is Taking Care Of Your Parents’ Teeth? Taking Dentistry Into Nursing Home Setting

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Grace_Dr_Lui__Smiles_as12By Dr. Grace Liu and
Dr. Lewis Yu

We make sure that our children and ourselves brush our teeth everyday and get dental checkups twice a year, but what about our geriatric parents living in nursing homes?

Senior citizens living in a nursing home setting have traditionally been an underserved segment of our population in terms of oral health care. We would like to use this opportunity to highlight some of the challenges that our seniors are facing and some possible solutions.

Our elderly parents face unique challenges in maintaining proper oral hygiene due to physical and/or mental disabilities that often come with old age. Reduced dexterity and eye-hand coordination translate directly to a lower state of oral health. On top of these physical obstacles, human emotions (such as pride, embarrassment, guilt) make it much more difficult for our elderly parents to accept help in brushing their teeth. The same set of emotions may also prevent us, the caregivers, from readily offering help in these mundane tasks and doing them with extreme care. For those senior citizens who live with their immediate families, they are more likely to enjoy a higher level of care from their loved ones. It is a different story for the ones who live in an institutional setting.

Most of the nursing home population are frail, medically compromised who would require more care than their family is able to give. Nursing home staffs have the underappreciated job of taking care of a large number of residents with a tight budget and resource constraints. It is possible under the previously mentioned circumstances that lower priority care items could be ignored
at times. Oral health care often falls into this category. Is it really a lower priority item?

Overall health starts at the mouth. Oral health and medical health are very much interrelated. Here are some examples: Proper digestion of food is not possible without good teeth. Gum disease is an infection that can lower the immune system’s ability to fight other sickness. Bacteria in gum infection has been linked to heart disease. Illness in other parts of the body may show signs in the oral cavity. Imbalance of the bite (such as a broken denture) may cause headache, neck pain, dizziness, hormonal imbalance, ear ringing. (see the article “TMD the Great Imposter”). This list goes on and on; however, there is one single most important factor in deciding how important oral health is. That factor is QUALITY OF LIFE. Of course, it is important for our body to function properly. However, what about how it effects our mental state? Would we be happier eating a juicy steak or drinking Ensure milkshakes through a straw? Depression is common among the geriatric population. Imagine how difficult it is for our elderly parents to slowly lose their independence. Under these circumstances, the simple pleasure of eating and tasting food has a great impact in lifting their spirits.

What Can We Do? Education

Our Team at All About Smiles has conducted many on site training sessions for nursing home staff. Our goals are to share with the staff techniques in assisting residents with oral hygiene procedures and in identifying signs of oral pathology and infections. We are happy to say that we are being received with great enthusiasm from the staff. It has been very gratifying to see these health professionals willing to learn so they can elevate the level of care to their patients.

Bringing The Dental Office into  Nursing Homes

Transportation is a common problem for home residents to receive dental care. With the advent of portal dental equipment, it is possible to perform some of the dental procedures in the nursing home. Procedures such as denture fabrication and repair, and teeth cleaning are within possibility. A dentist can perform regular checkups onsite and can contribute in the development of the comprehensive care
plan of each of the
individual residents.


Currently our office is gearing up to bring this concept to practice. At the request of the patients or their legal guardians, we would visit them at the facility as their private health care provider. In the first phase of this program, we would provide onsite semi-annual checkups (including x-rays) and limited cleaning. Most of the denture related procedures could be done onsite as well. For the patients who require the use of our dental office, we would schedule them to complete all necessary procedures in one visit. This would reduce the headache of transportation. Our boutique office in North Wilmington is well suited for this purpose. In the near future, we will be bringing a mobile dental facility to the nursing home.

As the population in the United States ages, the number of nursing home residents can only increase. Caring for the elders is one of All Abouts Smiles’ teams passions. Oral health care issues really should be raised in this discussion as a distinct topic, not as a secondary issue after medical care. After all, we are all going to get old.

Note:  Caring for the elders is one of our team at All About Smiles’ passions. If you would like us to speak with your group about geriatric care or any other dental related subjects, we would be very happy to do so.

Dr. Lewis Yu earned his dental degree from the University of Pennsylvania School of Dentistry in 1996. He received two years of advanced post-graduate oral surgery training in both the New York City Hospital System and the Hospital of the University of Pennsylvania. He continues his education through extensive hands-on training at the prestigious Las Vegas Institute for Advanced Studies and the Pankey Institute. The Las Vegas Institute has provided Dr. Yu with advanced training in Neuromuscular Dentistry and Comprehensive Aesthetic Restorations. He had practiced in Philadelphia and Newark, DE before joining All About Smiles, P.A. He is a member of the Delaware State Dental Society, American Dental Association, and  the Academy of General Dentistry.

Dr. Grace Liu has been practicing dentistry since 1996, having earned her degree from the New York University School of Dentistry. She continued her education through post-graduate studies at Columbia University, the Las Vegas Institute for Advanced Studies in Nevada and the Academy of Dentistry. She is also a member of the Delaware State Dental Society, American Dental Association, and the Academy of General Dentistry.