New Approach to Oral Hygiene Tailored to Patients with Dementia

Nurses who care for patients with dementia may soon have access to a tailored approach to dental hygiene for their charges, according to a new pilot study performed by a team of Penn State nurses reported in the current issue of Special Care in Dentistry.

Rita A. Jablonski, assistant professor of nursing, Penn State and her team have developed an oral hygiene approach called Managing Oral Hygiene Using Threat Reduction (MOUTh) specifically for patients with dementia. The nurses created 15 strategies that focus on making the patient feel more comfortable before and while care is provided.

These strategies include approaching patients at eye level if they are seated, smiling while interacting, pantomiming and guiding patients to perform their own care by placing a hand over the patient’s hand and leading.

Jablonski and her team conducted the pilot study with seven people who had either moderate or severe cases of dementia. The researchers used the MOUTh technique on the subjects for two weeks, recording the state of the patients’ mouths and how the patients reacted throughout the study.

At the beginning of the study all seven subjects had poor oral health—as determined by the Oral Health Assessment Tool. Eight categories concerning oral health are scored between zero and two; the lower the score the healthier the mouth. The average score for the subjects at the start of the study was 7.29. By the end of the study the average score was 1.00.

“To my knowledge, we are the only nurses in the country who are looking at ways to improve the mouth care of persons with dementia, especially those who fight and bite during mouth care,” said Jablonski. “Our approach is unique because we frame resistive behavior as a reaction to a perceived threat.”

The National Institutes of Health has awarded Jablonski a $1.4 million, four-year grant to continue this research.

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