Content Dam Diq Online Articles 2018 03 Sick Friend 1

Toothbrushes or tombstones? Dental assistant helped dying friend

March 19, 2018
Theresa Sheppard, RDA, knows what it's like to sit with a dying friend. She was by her best friend's side, and when she saw her friend's mishandled oral care from the ICU unit, she stepped in to help.

This article originally appeared in Dental Assisting Digest e-newsletter. Subscribe to this informative monthly ENL designed specifically for the dental assistant here.

Nearly everyone has that one person, that “bestie” they’ve been friends with forever, that person they grew up with, told secrets to, asked to stand up at their wedding, and went through both good and hard times. Most people hope to grow old with this person. For me, that person is Janet, and after 44 years we’re more like sisters than friends.

A few years ago, Janet suddenly became extremely ill. She was told she had a stubborn case of pneumonia. But it turned out to be stage 4 lung cancer and stage 2 lymphoma. There had to be a mistake. She had no risk factors! Unfortunately, the diagnosis was true.

With great sorrow, I watched helplessly as my best friend and sister, now weighing 92 pounds and incoherent, was dying. I sat for hours and held her hand. I was afraid if I left I might not see her again. While sitting with her and looking around her room, I noticed the orders on the white board next to her bed. Written in the oral care section was, “Take out partials and clean.”

I couldn’t believe what I was reading. First, these were the first oral care instructions I’d seen during my three days of sitting there. Second, why would they have orders to clean her partials when she did not have partials, but no orders to care for her teeth, which she did have?

I pulled up Janet’s lips and what I saw was appalling! Her tissue was glossy and hemorrhagic. Who in this ICU determined this care plan, I wondered? Who in this ICU was providing her oral care? This was no way to care for a patient. I was livid and you can believe I let everyone know it. I know the importance of the oral-systemic link, and I wanted to do whatever I could to give her a fighting chance and make her as comfortable as possible. I decided to provide her oral care myself.

Negligible oral care tragedies

While I cared for Janet, I thought about other situations I’d witnessed during my dental career. Two sad cases came to mind.

A nursing home called our office and said one of their patients was reluctant to eat. When they investigated, they discovered that she had a broken tooth. What we saw when she arrived was very disturbing. She had a lower removable partial that was so thick with calculus that “removable” was no longer an option. What the staff at the nursing home had thought was a broken tooth was actually a large piece of broken calculus that was sharp and cutting her tongue. No wonder she didn’t want to eat!

I pulled up Janet’s lips and what I saw was appalling! Her tissue was glossy and hemorrhagic. Who in this ICU determined this care plan, I wondered?

The other situation was with one of our elderly patients, who was a lovely lady. She had health issues and a full-time caregiver, so we hadn’t seen her for years. Her caregiver called and said she had an emergency. When they arrived, it was obvious that our patient had advanced periodontal disease and the condition of her mouth was detestable. She required several extractions but her health prevented return visits for further treatment.

Within a few weeks, she developed pneumonia and passed away. Based on the relationship that we know exists between periodontal disease and aspiration pneumonia, I can’t help but believe her oral condition was a contributing factor to her rapid decline and ultimate passing.

We can make a difference

As health-care professionals, only we can change scenarios such as these. We are in a position to change the outlook of patients and the direction of treatment. The oral-systemic link is real and lack of oral care is a main contributor not only to minor infections such as sinus and ear, but also to serious diseases such as cardiac disease, diabetes, cancer, stroke, and Alzheimer’s. Neglecting these conditions can have life-altering consequences (and even death) for all of us, but especially for those who depend on others for their care.

Mother Teresa said, “It is not how much you do, but how much love you put into the doing that matters.” With this knowledge, there are three things we must do.

We must educate

As health-care providers, we can’t teach others unless we have a full grasp of the oral-systemic link and how deadly it can be. Information on this topic is abundant , so there’s no excuse for ignorance.

We must engage

We must reach out and form partnerships with our medical peers so we can treat the whole patient. We are not part of just a “dentist with a practice.” We are part of an oral physician’s office and we should embrace that role. We have opportunities each day to improve the quality of life for our patients.

We must empower

Patients who take care of their oral health will see improvements in their physical health. They will not only feel better, they will also save money on doctor visits and medication.

We are the professionals. It is our responsibility to care for people and save lives. If not us, then who will take on this role?

You may be wondering how Janet is doing. We were able to get her transferred to Stanford University Hospital. She completed extensive treatment and, by the grace of God, she has been in remission for three years. I am thrilled to say she is feeling wonderful, looking beautiful, anticipating the birth of a new grandchild, and, like many women, complaining about her muffin top.

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Theresa Sheppard is a registered dental assistant with experience in all clinical and management aspects of the dental office. Her extensive hands-on and front-line experience of over 35 years makes her uniquely qualified to train dental teams. Her presentations provide the tools and systems necessary to become skilled in all aspects of clinical and administrative practices, risk management, patient/practice protection, HIPAA, and the oral-systemic link. She is the owner and director of Career Express Dental Assisting School, an instructor for the California Radiation Safety Course, and a California Dental Board Continuing Education Provider. Her presentation, “Deadly dental bacteria: Kill or be killed” can be customized to any audience or specialty practice. For more information, call (209) 222-0750 or email [email protected].