Wendy St. Cyr, RDH, who currently resides in New Hampshire, moved away from her native Utah almost five years ago. Yet she still appreciates the connection between herself and the Utah Dental Hygienists' Association.
She shares with the director of RDH eVillage how the UDHA has "spent many years creating the possibility of increasing the roles of dental hygienists in Utah."
Wendy explains, "I am so very pleased to see that it is progressing and getting some media coverage. Now that Utah has five dental hygiene schools instead of one � they have the numbers they need to unify a distinguished voice."
Wendy wants other hygienists to know that she is very proud of her association with the UDHA. She says, "I look forward to more amazing outcomes from their collective efforts."
After reading the following newspaper story, please contact Sheri Eurick, UDHA legislative chair, to learn how you can help to increase the access to oral health care in Utah. She can be e-mailed at [email protected].
The article below appeared in The Salt Lake Tribune and was written by Linda Fantin.
Janice Davis has survived brain aneurysms, a devastating stroke, and bouts with skin cancer, hip replacement surgery, and a rare neurological disorder in which the body is hypersensitive to pain. She can't speak, read, write, or walk. She's 83 and — this makes her smile — a bit of a perfectionist. So when it came time to shop for an elder-care facility, her husband had plenty of priorities. Dental care wasn't one of them.
"It never came up," says Jack Davis, a retired radiologist living in Huntsville. That was six years ago, before medications started rotting her teeth, before her dentist came up with a plan to save them, and before dental hygienists asked for more legislative leeway in caring for people like Janice and the other residents of Legacy House. Hers is a success story, an example of how cooperation can trump professional agendas to address a hidden problem among Utah's elderly — oral hygiene.
It's also rare.
Dentists in private practice have little incentive to venture into elder-care homes or to send their hygienists there, Davis says. They are busy enough with clients who come to them — paying clients, not those on
Medicare. There also are practical considerations. The portability of stethoscopes, ear scopes, thermometers, and syringes allows physicians to pop in on patients, conduct checkups, and make referrals and follow-up appointments.
Dentistry is best done in a big chair.
Then there's the issue of family support. "I've been hanging around these people for a long time and I could tell you some sad stories of old people getting dumped," Davis says.
Perhaps the biggest barrier, according to hygienists, is state law. In Utah, licensed hygienists cannot examine anyone who hasn't seen a dentist in the past six months, and they must have prior authorization from a dentist to do so. Hygienists, whose numbers have swelled in the past 10 years, are now asking the legislature to follow the lead of other states and give hygienists more freedom to work in public health settings, doing preventive care in nursing homes, low-income schools, clinics, and facilities for migrant workers. The proposal, Senate Bill 124, stalled in committee and is being massaged to address the concerns of dentists.
"We're available, we're trained, and we're ready and willing to do this type of work," says Sheri Eurick, legislative chair of the Utah Dental Hygienists Association.
The Utah Dental Association is skeptical. Members worry that hygienists, given too much autonomy, will miss diagnoses or make the wrong ones, putting patients and consulting dentists at risk. They see it as a first step toward independent practice. The problem, says UDA president Ron Bower, can be solved without legislative interference.
Just how big is the problem?
In a 2006 survey of Utah, 54 nursing home administrators, 31 percent, described dental care needs as severe, while 14 percent said they were satisfied with the level of preventive care residents receive. All but 10
percent supported greater access to hygienists.
Count Richard Monk in the majority. Monk is in charge of Legacy House in Ogden where Janice Davis is a resident. Legacy House has 80 assisted-living apartments, a library, a garden, a patio for barbecues, a beauty parlor, and, every Tuesday, an in-house physician.
Jane Dalton had her own doctor when she moved to Legacy House in November. But she appreciates the convenience of house calls and would like to have a dentist or dental hygienist drop by for consultations. Once every six weeks Monk receives a flier from a dentist new to the neighborhood. All insist that patients come to them.
"Only half of our residents have someone who takes them anywhere, let alone to the dentist," Monk says. "I wouldn't call it benign neglect but the situation is less than optimum."
Nurse's aides are trained in basic oral care and can assist residents with brushing and flossing. But without regular checkups and cleanings, problems tend to fester. "It's only when a resident is in pain or has
bleeding gums that we would know something is wrong," Monk says.
The elderly are not the only ones being forsaken. Consider the story of Debra Danel, a dental hygienist who was paralyzed in a car accident two years ago. Throughout her nine-week hospitalization, Danel had to constantly ask nurses for oral care, once going four days without getting her teeth brushed.
"I had an awareness there was a problem, but this was a big epiphany," she says. Danel found that many nurses, aides, and therapists are not trained in proper oral hygiene. Many have a reluctance to brush and floss because it can cause gums to bleed and patients to hurt. Still others have an aversion to saliva.
"All it takes is for somebody to say, 'I don't want my teeth brushed right now,' and they move on to the next patient. They get busy and never come back," Danel says. But Danel was persistent. She taught her caregivers proper brushing and flossing techniques, improved her care and that of other patients at the
rehab hospital. Some of the aides even started taking better care of their own teeth, too, Danel said.
Likewise, the certified nursing assistants who work at Legacy House are much more diligent after working with Janice Davis. Within a year of moving to Legacy House, Janice's teeth were falling apart, her gums were inflamed and bleeding, and the skin between her teeth was almost gone.
The culprits were three medications Janice depends on to relieve pain and help with bladder control. The Davises were in a quandary. They could save Janice's teeth and watch her writhe in pain, or forget the teeth and keep her on the drugs. Her dentist, David O. Hendrickson, invented a third option: A comprehensive oral health program that involves swishing and sponging and brushing and flossing after every meal. Hendrickson put a hygienist in charge of implementation, and she enlisted the help of the nursing aides at Legacy House. Janice's sink is crowded with special toothpastes and fluorides and saliva-in-a-can. The page-long list of directions is taped to her mirror, along with her dental report cards.
"They're as exquisite as they ever were," Davis says, lifting his wife's upper lip to show how the skin between her teeth has grown back. Davis has lots of ideas for improving dental care in Legacy House, like putting a dental chair in the beauty parlor. But he's not keen on the idea of hygienists going it alone. "The people who ought to be working on this are the dentists," Davis says. "They need to find a way to send the hygienists to these places. If they did that, they wouldn't have to ask the legislature to get involved."
