Nutrition Starts In Your Mouth

 Without a doubt, health and nutrition go "hand in hand." That's why it's crucial to keep your teeth and gums in the best of shape at all times. 

As a child, you learn to brush every night before going to bed, and if possible, after meals.  And as you get older, you're taught how to floss and use a Waterpik to keep the gums healthy and avoid buildup between your teeth. Eventually, oral care has become a daily or twice a day habit throughout your life.  

However, as people grow old or may no longer be able to care for themselves, the need for others to help with what we call the "activities of daily living" increases, including personal hygiene and oral care.  

But sadly, this assistance is not always provided in facilities if there is no time or lack of staff.  Often, when I was on a survey, I noticed that residents didn't even have toothpaste or a toothbrush, which meant oral care did not occur. The beginning of the nutrition line was deficient, and the nursing standard of care was not provided by nursing staff.  

Usually, personal hygiene and activities of daily living are provided by nurse aides who are often stretched for time. When a high resident/patient load is assigned to them, oral care may never happen. 

As I have learned from medical record review, sometimes this care is documented or "checked" off as provided when it has not been provided.  Always review the activities of daily living in the medical records, what was needed, and what was actually provided. 

Was there documentation when the resident was not in the facility? If this is found to be the case, the entire integrity of the medical records may be in question. 

Let me share an example with you… 

A fifty-year-old man who suffered a stroke (cardiovascular accident) had to be placed in a long term care facility, a "nursing home." Unfortunately, his family lacked the funds to continue to take care of him at home.  

When he entered the facility, his teeth were in good condition. He had seen a dentist regularly for his dental needs, and according to his wife, he completed his oral care daily.  

But when his wife visited the nursing facility, she would find that his teeth had not been brushed, and he had severe bad breath. She would speak to the nursing team, leave the staff a note in the bathroom, and speak to the charge nurse on duty. Unfortunately, oral care was never provided, and he eventually developed gum disease.  

As a result of the gum disease, he lost all his teeth. Due to the cost of dentures, his family was not able to provide this need. A resident on public aid only receives about $30 per month for personal needs; dentures were out of the question. 

Since he could not chew his food, a pureed and paste-like diet was provided to him.  He no longer had the dignity of enjoying foods he had in the past, his nutrition needs were not meet, and his health declined. 

If a resident uses dentures, they need to be kept clean and always in a safe place at night, if not worn at nighttime. A dentist should also mark the dentures before a resident enters a facility or hospital. When dentures are obtained initially, it is good practice to have the name or initials put on the upper and lower plates or bridges. 

When I took nurse aide students into a facility for training one morning, the staff were a bit upset. Apparently, during the night, the night shift staff had not noticed a wandering resident. Frequently, the night staff covers a large number of residents, and even one staff member could be covering more than one floor within a facility. 

That is why oversight and providing the night care needed can be deficient. Staff is set up to fail even before coming to work due to the work schedule and demands. 

This particular morning, the night wandering resident had gone into other residents' rooms and took denture cups with the soaking dentures. While the storage cups were labeled, the dentures themselves had not been marked with the resident's name. 

The wandering resident had taken all the dentures cups to the floor bathroom, filled the bathtub, and put all the dentures into the tub to be soaked and washed.  Hence, when the day staff was getting the residents up for breakfast, they were not able to find the residents' dentures.

After some detective work, the bathtub full of floating dentures was discovered. Since none of the denture plates had any names on them, a dentist had to be called to clean the dentures and find the rightful owner of each denture pair.  

Keeping your teeth in good order, cleaned, brushed, and flossed is essential to your general health, dignity, and quality of life. In the event plates, bridges or dentures are needed, please be sure your initials or name are marked on them. 

On a side note, many bridges are made of valuable materials, including gold, and can be sold at a later date. One family's bridge was turned in for sale and recently brought $900 due to the gold content. So be sure to never throw away old bridges and plates without checking into the value first.