Oral Health Care Access and Adequacy in Alternative Long-term Care

Objectives: To determine practices and perceived access barriers (facility resources, attitudes, and professional dental involvement) related to oral health by surveying administrators in Michigan alternative long-term care facilities (ALTCF) such as assisted living. Methods: A 24-item questionnaire exploring aspects of oral health was mailed to all 2275 Michigan ALTCF serving residents aged 60+. Descriptive statistics were calculated for response items. Results: Facility response rate was 22% (N=508). 11% of facilities had a written dental care plan. 18% stated an examination by a dentist was provided to new residents. 19% of facilities have an agreement with a dentist to come to the facility, with 52% of these being for emergency care only. 80% of responding administrators indicated satisfaction with how oral hygiene needs were met in their facilities. Almost half of residents in ALTCF were perceived to be dependent in oral hygiene. The greatest perceived barriers to improved oral health were willingness of general and specialty dentists to treat residents at the nursing facility and/or their private offices as well as financial concerns of the resident and/or family. Having professional care and staff training provided without cost to the facility were most often suggested to improve oral health care. Generally, greater resources were available in larger facilities, but substantial barriers to care are uniformly perceived. Conclusion: Oral health policies and practices within Michigan ALTCF vary, as measured by resources, attitudes, and the availability of professional care. Dental involvement in policy creation, provision of consultation, and service is limited. Study supported by Project Grant F013480/050989, NIH/U of MI Pepper Center.