Oral Health in Long Term Care (LTC) Home in Saskatchewan – History

During 2007-2008, two pilot projects began in Saskatoon and Regina to improve access to dental treatment for LTC residents.

In Regina, Santa Maria LTC home developed a fully equipped dental operatory.  Oral health professionals volunteered to provide free oral health assessments.  Identified treatment was provided on site in the dental operatory for residents who consented to treatment.  Treatment was paid for by the resident or their family.

In Saskatoon, a collaborative approach was taken with the University of Saskatchewan, College of Dentistry, Saskatoon Health Region (SHR), and private practice dentists.  Portable equipment was used at St. Anne’s Home and the Saskatoon Convalescent Home to provide identified dental treatment to residents (paid for by the resident or their family) who consented to treatment following a free assessment.

To date, the Regina Santa Maria project operates in the same manner as when implemented.  In Saskatoon, the private practice dentist continues to provide dental treatment using portable equipment, to consenting residents at several LTC homes in the Saskatoon Health Region.

In Saskatoon, it was determined that dental treatment could be provided more effectively and efficiently with support from an “oral health coordinator”.  The coordinator would be a liaison with the LTC home and would arrange clients’ appointments and schedules with LTC staff more effectively.

In 2011, the University of Saskatchewan, College of Dentistry, and SHR Seniors’ and Continuing  Care and Population and Public Health, teamed up and applied for a SHR Community Wellness Grant.  The grant request was successful, and was used to fund a dental assistant via the College of Dentistry.  The dental assistant became the LTC oral health coordinator.  In addition, the College of Dentistry directed dental residents (dentists who are doing a one year internship) to provide free oral health assessments for residents at Parkridge Centre and Sherbrooke Community Centre LTC homes.  The LTC oral health coordinator assisted the resident dentists, provided all administrative support and worked cooperatively with LTC staff to ensure clients and their families received information, communication, scheduling, etc..

A program evaluation showed this model worked well.  It increased staff/resident understanding, reduced the number of clients who missed appointments or were not prepared for treatment, and provided a liaison between the LTC home and the dental providers.

The dental resident/LTC oral health coordinator model works well in SHR.  This model needs to be self-sustaining and to assist with this in the future, assessments will be covered by dental insurance and/or resident self-paid.

In 2010, the Saskatchewan Oral Health Coalition (SOHC) began.  It is a group of oral health professionals, community agencies, health region staff, provincial and national government representatives, and interested groups and individuals whose common goal is to improve oral health, particularly among vulnerable populations.  In 2011, the SOHC identified oral health in LTC as the number one priority.

Since 2011, the SOHC and the Saskatchewan Oral Health Professions (SOHP) group have worked collaboratively to develop a Saskatchewan strategy for oral health in LTC.  This process included a best practice literature review, policy and procedure review, and collection of various oral health data related to LTC and pilot projects in Saskatchewan.

In 2011, the SOHP and SOHC endorsed the use and adaptation of Better Oral Health in Long Term Care – a training resource that is a national program in Australia.  The resource license was agreed to between SHR and Australia.  The license allowed for Saskatchewan adaptations.  During 2011-2013, SOHP representatives worked to modify the training resource to Canadian/Saskatchewan standards.  In 2013, the resource was retitled Better Oral Health in Long Term Care – Best Practice Standards for Saskatchewan. 

In fall of 2013, SHR will be focus testing the Better Oral Health in Long Term Care – Best Practice Standards for Saskatchewan at Parkridge Centre.  Parkridge staff decided to begin with training staff in two of their neighborhoods to provide daily oral care.  Daily oral care has not been routinely provided, even though dental treatment has been available for Partridge residents for the past few years.  SHR PPH staff will assess residents prior to training staff.  The daily oral care program will be implemented by special care aides and after 6-8 weeks, an oral health reassessment will occur.  Expansion to other Parkridge neighborhoods and LTC homes in SHR will follow, if the focus testing is successful.

The SOHC & SOHP group is completing a report on the Saskatchewan Strategy for Oral Health in LTC that will include recommendations for provincial authorities to consider.

Improved oral health in LTC can improve overall health, reduce hospitalizations, and significantly improve quality of life.

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