Mobile Dentistry
Tom Seal, DDS and his staff visit private residences, assisted living facilities, hospitals and nursing homes to deliver dental care for home-boundwww.paths-afh.com patients around the area. Using state of the art diagnostic oral devices they are able to do oral cancer screenings and perform oral biopsies. They will also note existing restorations, identify periodontal status, and factor in all existing conditions and medications to provide comfort and function. Depending on the patient’s health history, Dr. Tom Seal and his staff will monitor for infection and provide cleanings, fillings, dentures, and most extractions without the client ever needing to leave their own home. Dr. Tom Seal and staff have worked with several community health centers, hospitals, nursing homes, assisted living facilities, and substance abuse rehabilitation facilities. The State of Washington sent Dr. Seal and other mobile dentistry providers to the national geriatric dental conference to be trained in meeting the dental needs of the elderly population. With this information we are able to deliver established standard of care practices to enable the people we serve. If we can assist you in the care you provide, please call our office at (425)823-9000.
Defining Oral Neglect in the Institutionalized Elderly
Concerns about patients receiving insufficient care in nursing homes resulted in the Omnibus Budget Reconciliation Act of 1987 (OBRA 1987). In 2009 the Delphi survey technique was used to develop a professional definition of oral neglect. The panels’ definition of oral neglect in the institutionalized elderly was established and consists of twenty-nine oral diseases and conditions, each of which is associated with a specific time period to establish neglect and comprise a diagnostic stage. This definition provides a utilitarian means to enforce the OBRA 1987 legislative expectation concerning federal funds payments to nursing homes. If your facility does not receive federal funds, the definition and categories provide you with a standard of care to evaluate the severity of your patients’ dental needs. Included is the Final 2009 Consensus Definition of Oral Neglect for the Institutionalized Elderly. As a geriatric dentist we can assist your facility in improving, attaining and maintain the highest practical physical, mental and psychosocial well-being of these elderly patients, in symbiotic association with your staff.
Final 2009 consensus definition of oral neglect for institutionalized elderly.
ORAL NEGLECT IS PRESENT WHEN:
any one of the following 29 oral diseases or conditions is present at the specified diagnostic stage.
Oral Disease or Condition Diagnostic Stage
Subjective symptoms category
Swallowing dysfunction Mild
Pain Moderate
Chewing dysfunction Moderate
Halitosis Moderate
Change in taste Moderate
Dry mouth Moderate
Objective soft-tissue category
Oral/facial swelling Mild
Fixed red lesion Mild
Fixed white lesion Mild
Tumor Mild
Pigmented lesion Mild
Candidiasis Moderate
Cuts or abrasions Moderate
Bleeding Mild
Objective conditions in dentate patients category
Coronal caries Mild
Root caries Mild
Abscess Mild
Root tip retained Mild
Poor oral hygiene Moderate
Periodontitis Moderate
Broken tooth Moderate
Gingivitis Severe
Gingivitis hyperplasia Severe
Objective conditions in edentulous patients category
Lost denture Not applicable
Broken prosthesis Mild
Epulis fissuratum Mild
Poor prosthetic hygiene Moderate
Papillary hyperplasia Moderate
Ill-fitting prosthesis Moderate
AND
the following “time-to-qualify-as-neglect” criteria were exceeded for the stage of any one of the oral diseases or conditions present:
Stage of the Oral Disease
or Condition Detected-to-
Diagnosed Phase Diagnosed-to-
Care Phase Total Time for
Oral Neglect
Acute 3 days + 5 days = 8 days
Chronic 14 days + 21 days = 35 days
Tom Seal, DDS and his staff visit private residences, assisted living facilities, hospitals and nursing homes to deliver dental care for home-boundwww.paths-afh.com patients around the area. Using state of the art diagnostic oral devices they are able to do oral cancer screenings and perform oral biopsies. They will also note existing restorations, identify periodontal status, and factor in all existing conditions and medications to provide comfort and function. Depending on the patient’s health history, Dr. Tom Seal and his staff will monitor for infection and provide cleanings, fillings, dentures, and most extractions without the client ever needing to leave their own home. Dr. Tom Seal and staff have worked with several community health centers, hospitals, nursing homes, assisted living facilities, and substance abuse rehabilitation facilities. The State of Washington sent Dr. Seal and other mobile dentistry providers to the national geriatric dental conference to be trained in meeting the dental needs of the elderly population. With this information we are able to deliver established standard of care practices to enable the people we serve. If we can assist you in the care you provide, please call our office at (425)823-9000.
Defining Oral Neglect in the Institutionalized Elderly
Concerns about patients receiving insufficient care in nursing homes resulted in the Omnibus Budget Reconciliation Act of 1987 (OBRA 1987). In 2009 the Delphi survey technique was used to develop a professional definition of oral neglect. The panels’ definition of oral neglect in the institutionalized elderly was established and consists of twenty-nine oral diseases and conditions, each of which is associated with a specific time period to establish neglect and comprise a diagnostic stage. This definition provides a utilitarian means to enforce the OBRA 1987 legislative expectation concerning federal funds payments to nursing homes. If your facility does not receive federal funds, the definition and categories provide you with a standard of care to evaluate the severity of your patients’ dental needs. Included is the Final 2009 Consensus Definition of Oral Neglect for the Institutionalized Elderly. As a geriatric dentist we can assist your facility in improving, attaining and maintain the highest practical physical, mental and psychosocial well-being of these elderly patients, in symbiotic association with your staff.
Final 2009 consensus definition of oral neglect for institutionalized elderly.
ORAL NEGLECT IS PRESENT WHEN:
any one of the following 29 oral diseases or conditions is present at the specified diagnostic stage.
Oral Disease or Condition Diagnostic Stage
Subjective symptoms category
Swallowing dysfunction Mild
Pain Moderate
Chewing dysfunction Moderate
Halitosis Moderate
Change in taste Moderate
Dry mouth Moderate
Objective soft-tissue category
Oral/facial swelling Mild
Fixed red lesion Mild
Fixed white lesion Mild
Tumor Mild
Pigmented lesion Mild
Candidiasis Moderate
Cuts or abrasions Moderate
Bleeding Mild
Objective conditions in dentate patients category
Coronal caries Mild
Root caries Mild
Abscess Mild
Root tip retained Mild
Poor oral hygiene Moderate
Periodontitis Moderate
Broken tooth Moderate
Gingivitis Severe
Gingivitis hyperplasia Severe
Objective conditions in edentulous patients category
Lost denture Not applicable
Broken prosthesis Mild
Epulis fissuratum Mild
Poor prosthetic hygiene Moderate
Papillary hyperplasia Moderate
Ill-fitting prosthesis Moderate
AND
the following “time-to-qualify-as-neglect” criteria were exceeded for the stage of any one of the oral diseases or conditions present:
Stage of the Oral Disease
or Condition Detected-to-
Diagnosed Phase Diagnosed-to-
Care Phase Total Time for
Oral Neglect
Acute 3 days + 5 days = 8 days
Chronic 14 days + 21 days = 35 days
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