Invitation boosts participation
In a recent study, Manitoba dentists reported a low rate of providing care to residents of long-term care facilities. A key reason they’re staying away, the study found, is that no one has invited them.
Of about 300 general dentists in Manitoba who participated in the anonymous study, only about one-quarter (26 per cent) said they currently treat long-term care residents.
Respondents’ most frequently identified barriers to providing care were having a busy private practice (60 per cent), never having been invited/asked to provide care (53 per cent), and a lack of mobile dental equipment or lack of a designated dental room in the long-term care facility (43 per cent).
Among dentists who do provide care to residents, either at a facility or at their own practices, the most common reasons were being asked or invited to do so (52 per cent), seeing it as a professional obligation (49 per cent), and having a past or current family member or patient in long-term care (40 per cent).
“These findings indicate that if dentists were directly asked, and were more familiar with the need for oral care at these facilities, the participation rate would be higher,” says Shelley Tang [B.Sc. (Dent)/18, DMD/18], a recent dentistry graduate.
Tang conducted the study of dentists’ views on treating long-term care residents in 2016 as the research project for her bachelor of science in dentistry.
Robert Schroth [DMD/96, M.Sc./03, PhD/11], associate professor of preventive dental science, was her advisor, along with Pamela Dahl [DMD/96] and Mary Bertone [Dip.D.Hyg./05, B.Sc.D.Hyg./11, MPH/15].
The Manitoba Dental Association (MDA) provided summer studentship funding for Tang to undertake the research.
The association’s long-term care committee commissioned and played a role in the study.
The MDA emailed its general dentist members a link to the study questions and asked them to take part.
Previous Canadian studies have shown that people living in long-term care facilities are prone to poor oral health, complicated by factors such as complex medical conditions, side effects from medications, physical and cognitive decline and limited access to care, Tang says.
“Long-term care residents are a vulnerable population,” she says. “They may depend on facility staff to maintain their oral health, because self-care may be difficult. Staff may lack the time or training to perform daily oral health care. Unfortunately, there are currently no standards for daily mouth care in long-term care facilities.”
Rural dentists in the Prairie Mountain Health and Southern Health-Santé Sud regions had a higher rate of treating long-term care residents than dentists in Winnipeg.
“In the city, many dentists assume ‘someone else is doing it,’ whereas in rural areas dentists tend to feel more responsible for a whole community,” Schroth says.
When dentists who don’t provide care to long-term care residents were asked what would motivate them to do so, the top two responses were having proper portable equipment or a designated dental room in long-term care facilities (61 per cent) and receiving an invitation to provide treatment (43 per cent).
Some dentists who currently provide care said one of their reasons was that they were exposed to long-term care patients during their dental training.
“Education is the key,” Tang says. “Dentists need to be better informed about the unmet need for care.
The management of long-term care facilities needs to know how to approach dentists and what equipment, space, support and information dentists require in order to say ‘yes.’ “Nursing staff, those who reside in long-term care facilities and their family members also need oral health education.
By fitting all these pieces together, the Manitoba dental community can improve service to this population.”