Oral Health Care of Nova Scotia Seniors

Let’s Talk Policy

Terry Mitchell, BSc, RDH, MEd, CGN School of Dental Hygiene, Faculty of Dentistry

Dalhousie University

Research question

• What are the key components of an oral health action plan, based on continuity of care, which will improve the oral health status of seniors in Nova Scotia?

Project objectives

• Health services evaluation• Promising practices scan• Forum • Dissemination & communication

Health services evaluation

• Focus groups• Key informant interviews

Promising practices scan

• Literature search• Informal discussions, key service delivery

Forum

• Data to date– Power point– Story-telling

• Multi-sector small working groups

Dissemination & communication

• Conferences• Reports• Journal articles• Newsletter• Etc.

Oral Health of Seniors Project Team

Aileen McCormick, Senior Representative Debra Matthews, Faculty of Dentistry,

Dalhousie University Don Pamenter, Nova Scotia Dental

Association Gael Page, Northwoodcare Inc. Gail Brown, Nova Scotia Dental Hygienists’

Association Gerard Ferguson, Manulife Financial Herenia Lawrence, Faculty of Dentistry,

University of Toronto James Leake, Faculty of Dentistry,

University of Toronto Joseph Murphy, Faculty of Dentistry,

Dalhousie University Murray Nixon, Nova Scotia Department of

Health

Patty Williams, Department of Family Studies, MSVU

Robert MacDonald, Faculty of Dentistry, Dalhousie University

Sandra Crowell, Atlantic Health Promotion Research Centre

Scott MacLean, Practicing Dentist Terry Mitchell, School of Dental Hygiene,

Dalhousie University Valerie White, Nova Scotia Senior Citizens'

Secretariat William MacInnis, Faculty of Dentistry,

Dalhousie University Elizabeth Tait, Project Coordinator, Oral

Health of Seniors Project Pamela Magee, Researcher, Oral Health of

Seniors Project

Principal investigators: Mary McNally, Faculty of Dentistry, Dalhousie UniversityRenée Lyons, Atlantic Health Promotion Research Centre

Funders• CHSRF• NSHRF• Drummond Foundation• Manulife Financial• Nova Scotia Dental Association• Dentistry Canada Fund• CIHR for Forum Funding

Forum

Participants• Seniors from

community• Government• Researchers• Service & health care

businesses• Associations

Action plans• Collaboration Steering

committee• Policy development• Public awareness• Program delivery• Geriatric education of

oral health care students• Geriatric education for

non-oral health care providers

• Research

Policy implications

• Oral health must be explicitly recognized as an essential component of overall health and quality of life.– Increase awareness of decision-makers, public– Integrated health systems: coordinate private &

public services

Policy implications

• Infrastructure at either the provincial or federal government levels must be established for oral health care for seniors– Leadership position in Health Canada,

Provincial Departments of Health– Prevention, promotion of oral health care

integrated with public, primary healthcare programs

Infrastructure (continued)

• Review relevant legislation impacting oral health

• Oral health programs• Guidelines for private & public continuing care

facilities - oral health standards & service provision

• Oral health exam component to “single-point” entry protocols

Policy implications

• Increase accessibility of oral health care services especially for rural dwelling, homebound, and long term care residents– Mechanisms for service delivery, transportation– LTC facilities for on-site care delivery– Standardized oral health resource kit for non-

dental care providers– Oral health care labour force issues

Policy implications

• Investigate alternate methods of compensation for oral health professionals. – Impact of poor oral health on healthcare and

other social systems– Quantify financial support required (public &

primary health care for seniors)– Develop and evaluate dental service fee guides

specific to geriatric dental care

Policy implications

• Foster research initiatives to establish data pertaining to oral health and oral health practises– National consensus for oral health assessments

for seniors– Assess oral health status of seniors

Research (continued)

– Collaborative research teams• Develop & evaluate oral health promotion and oral

disease prevention strategies• Develop and evaluate dental practice guidelines

specifically for seniors’ needs• Determine the feasibility & mechanisms for

integrating oral health interventions and practices into existing primary health care strategies

• Assess the impact of the aging population on the dental workforce

• Develop & test service delivery models

Policy implications

• Education for care providers and those who educate care providers must acknowledge the need for specific geriatric education– Accreditation standards: dental , dental

hygiene, health related professions– Non-traditional delivery models educational

components– Geriatric dentistry - specialty recognition

Education (continued)

– Geriatric education for health care workers• Nursing• Continuing care assistance• Pharmacy• Medicine

– Caregivers who provide personal care

Current status

• Report submitted• Seniors oral health collaboration• COHR• Dissemination