1. Oral Health Assessment of Seniors 2009 The Massachusetts Experience
Lynn Bethel, RDH, MPH Director, Office of Oral Health
Massachusetts Department of Public Health

2. About Massachusetts 13.3% of residents are 65 years of age or older
Ranks 12th in the country for having the highest population of seniors
46,000 residents are in nursing home care

3. 44.8% of MassHealth eligible residents in LTC facilities utilized the dental benefit FY’07
27% of MassHealth members over the age of 60 utilized the dental benefit in FY’ 07

4. Collaborators Harvard School of Dental Medicine
Executive Office of Elder Affairs
Massachusetts Senior Care Association
MDPH Office of Healthy Aging

5. Purpose
To identify the oral health needs of low income seniors and those residing in long term care facilities
To promote and improve the oral health needs of seniors

6. Sampling Random Sample Originally 42 sites Ended with 41 sites**
Congregate Meal Sites
Long Term Care Facilities
Originally 42 sites
6 (3 of each type) dropped out, but most replaced
Ended with 41 sites**
21 LTC Facilities (n=834)
20 Meal Sites (n=212)
**Rural was recognized

7. Components of the Assessment
Dental Screenings-Office of Oral Health Staff
Soft Tissue Screening (Oral Cancer)-Harvard Residents and Faculty
Referrals for Restorative Treatment
Oral Hygiene Products

8. Process-Before the Screening
Introductory Letter with Survey
Executive Director
Medical Director
Follow-up Phone Call-Schedule Screening/Q&A
Follow-up Letter, Poster (and Consent Form)

10. Screening Indicators-LTC/MS
Demographics
Functional Disability
Presence of Pain
Edentulism
Presence & Function of Dentures
Soft Tissue Lesion
Untreated Decay
Gingivitis
Xerostomia
Oral Hygiene
Treatment Urgency

11. Screening Indicator-MS
Prescription Medication
Private Dental Insurance
MassHealth (Medicaid)
Dentist
Last Dental Visit
Tobacco Use
Alcohol Use

14. After the Screening Screening Report
Letter to dentist of record with permission from meal site participant
Referral given
CHC Dental Programs
MassHealth Dentist
Thank You Letter to Site and Survey ?

16. Looking Back…
Meal Site: Seniors concerned about what their friends would think and knowledge of their dentures
Nursing Home: Bed to bed
Re-calibrate mid-screening
One recorder per screener
No more than 2 screenings each week
Be Flexible...

17. “The facility must care for you in a manner that enhances your quality of life.” Long Term Care Resident Rights

20. Where do we go next… Release Report Policy Changes
Education of the Children
Back to Basics…“Reality Dental Care”
Encourage use of Public Health Dental Hygienists

21. Remembering “Ellie”...

22. Check out our oral health blog http://publichealth.blog.state.ma.us
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