How does oral care impact the risk of death in a nursing home?




Aspiration pneumonia is a leading cause of death in nursing homes. Aspiration pneumonia occurs when a non-air substance (e.g. food, liquid, saliva) and bacteria from the mouth is inhaled and infects the lungs. Oral health, including consistent, effective oral care, is linked to overall health. For example, poor oral health has been found to contribute to heart disease, kidney disease, and diabetes among other conditions exacerbated when bacteria enters the blood stream through the mouth.

Consider these simple QAPI oral care program checkups:

  1. Conduct care plan audits. Do care plans address oral care and resident specific needs (e.g. presence of a partial, denture care, etc.)
  2. Review training curriculum and conduct competency skills checks. Are staff effectively trained to recognize and report gum disease, broken/decayed teeth, sores and signs of oral cancer? Does training include strategies for proper oral care for residents with dementia and/or behavioral health disorders?
  3. Review assessment protocols. Are effective oral/dental health assessments conducted per policy for all residents? Are follow up assessments completed on those with identified risks—e.g. to review presence of dry mouth in residents on medications with this potential side effect?
  4. Ensure twice a day toothbrushing and regular flossing or use of an interdental brush; dentures should be cleaned after meals and out of the mouth soaking at night to help prevent mouth sores. Turn unconscious residents on their side during oral care to reduce the risk of aspiration. Conduct care observations and care plan intervention implementation compliance checks. (see ADA guide to toothbrushing)




Amie Martin, CDP, CHC, RAC-CT, MJ

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