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Nurses create tool to improve oral health in aged care

Nurses create tool to improve oral health in aged care

Chanelle Lawn and Brooke Hermansson - Photo by Louise Barker

Two enterprising nurses at Red Cliffs’ Jacaranda Village Aged Care have developed a tool to make it easier for staff to check residents’ oral health.

Registered nurse Chanelle Lawn and enrolled nurse Brooke Hermansson developed the tool after noticing that oral health can get overlooked in aged care.

Using the tool, staff can refer to a checklist which provides signs of healthy and unhealthy lips, tongue, teeth and gums, dental pain, oral cleanliness and saliva, and what action to take if unhealthy signs are noted.

For example, the checklist prompts staff to check whether a resident’s tongue is moist and pink or coated, ulcerated, swollen, patchy/fissured or dry/rough.

The checklist is also helpful as a tool to use with residents who have dementia and may not be able to readily communicate about their oral health issues. By running through the checklist, staff are able to better identify oral health issues and take appropriate action. The pair has also made videos to use with the tool, showing how to fit a denture, how to brush teeth correctly, how to remove a denture, and how to manage the oral health of residents with behavioural issues.

The tool should be used once per month for each resident, Chanelle said.

Chanelle and Brooke said the CEO had told them that use of the tool had spread to other facilities.

‘I think it has made a difference in staff being more aware,’ Chanelle said. ‘More of our residents are getting referred to the dentist.’

Poor oral health can cause pain, infection, difficulty swallowing and chewing, and loss of quality of life.

‘It can also cause social isolation for residents if they don’t have a proper (fitting) denture because they don’t want to come out and eat with other residents,’ Chanelle said.

The toolkit notes that older people tend to be prescribed more medications which can lead to residents having a dry mouth. The toolkit cites the most common oral health conditions in residential aged care facilities as:

  • angular cheilitis – bacterial or fungal infection around the corners of the mouth leaving a reddened or cracked appearance
  • glossitis – fungal infection of the tongue leaving it reddened in appearance
  • oral thrush – a fungal infection that appears in white patches usually on the tongue
  • gingivitis – dental plaque accumulation on the gum line leaving swollen red gums
  • periodontitis – gums and bone that support the teeth are reddened and broken down

Chanelle and Brooke studied a Diploma of Nursing together, graduating in 2012 and then worked together at Broken Hill Hospital. Chanelle started working at Jacaranda Village two and a half years ago, with Brooke starting work there six months later.

‘We’re wanting to do the best thing by our residents and improve their overall health,’ Chanelle said.

The two have also experimented with different emollients to moisturise residents’ limbs and prevent pressure sores and will develop a speech pathology tool.