In Vancouver’s Chinatown, there are more than 250 seniors who never have to leave home to see the dentist. Thanks to a unique UBC program, oral health care professionals come to them.
In 2011, the Faculty of Dentistry launched the “adopt a long-term care facility” initiative, which provides high quality care at no cost to residents at the Simon K.Y. Lee Seniors Care Home and Villa Cathay Care Home.
The creator of the program, UBC dental geriatrics expert Dr. Chris Wyatt, says the main goals are to treat at-risk seniors while providing a dynamic learning environment for students. With seniors as the fastest-growing population, says Wyatt, there’s a need for dentists, dental hygienists and dental specialists such as prosthodontists, who focus on restoring or replacing teeth, to treat elderly patients—not only at their offices but also in hospitals and care facilities.
Meeting the gaps in oral health care for seniors has been a longstanding goal for Wyatt and faculty colleague Dr. Michael MacEntee. In the late 1990s, they established the ELDERS (Elders Link with Dental Education, Research and Service) to deal with this unmet need, earning the Faculty international acclaim for its innovations.
“Our studies show that seniors lack access to dental care especially in long-term care facilities,” says Wyatt, professor and head of the prosthodontics and dental geriatrics division.
A major barrier to oral health care is cost. A 2009 Statistics Canada report showed that more than one Canadian in 10 avoids full dental treatment over the course of a year because they can’t afford it. If left unattended, dental problems in a vulnerable elder can lead to unnecessary infections, disease or premature death.
But seniors who can afford care may still face hurdles, says Wyatt. “We have also found that dentists may hesitate to treat elderly patients who are very frail or face complex health challenges.
However, UBC aims to reverse this trend, he says. “To increase access and address oral disease, we decided to develop the first program of its kind in Canada where seniors receive free care provided by our students under close clinical supervision.”
Wyatt adds, “We want to give our dental and dental hygiene students the experience of treating vulnerable populations so they can include these patients in their practice.”
UBC students complete rotations under the supervision of practicing dentists and UBC professors. They treat elders with dementia and painful physical disabilities such as rheumatoid arthritis, which make dental care challenging. Students have an opportunity to work with other health care professionals to better understand how to care for patients with complex medical, physical and psychological conditions.
UBC graduate student Dr. Angela Wong completed a general practice residency where she treated residents at Simon KY Lee Seniors Care Home during 2009–2010.
“I learned the importance of tailoring the treatment according to the patient’s medical history,” says Wong, currently in her third and final year of the graduate prosthodontics program.
Wong recalls treating a 76-year-old patient, a woman “on heart medication that thins the blood so we had to ask their physician to change the dosage before doing a tooth extraction.”
Paying attention to the elder’s stamina was critical, says Wong. “We would opt to observe and maintain a tooth for as long as possible rather than extract or place a crown if the patient could not tolerate long, complex treatment.”
Wyatt says many older adults are keeping their natural teeth longer. At the Villa Cathay Care Home, for example, close to 70 per cent of the senior residents have some natural teeth compared to 60 per cent in 2002. Oral care now goes beyond keeping the residents’ dentures clean.
“What we’re going to see are baby boomers who have been receiving excellent dental care throughout their life. They will expect that to continue whether it’s at their dentist’s office or at a long term care facility.”
To learn more about UBC geriatric dentistry programs, visit: http://www.dentistry.ubc.ca/features/documents/Elders_Wisdom.pdf