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Course helps dentists learn work in long-term care facilities

January 04, 2016

By Michelle Manchir

Dr. Doring
Dr. Charles Doring, a staff dentist at a nursing home in Rockville, Maryland, knows the anxiety and challenges that can come with treating older patients.

"Some (senior patients) may have complicated medical histories. It's not unusual when I'm reviewing the chart for a new patient to see they're on 20 medications that have multiple side effects, particularly in the mouth," said Dr. Doring.

Complicated as it may be, more and more dentists may notice their older patient base increasing in size as adults live — and keep their natural teeth — longer.

The Association is offering an online continuing education course in dental care for older adults in nursing homes, assisted living facilities and senior centers.

The continuing education, which is self-paced with eight chapters, offers 10 hours of CE and covers how long-term care facilities are organized and who works there; regulatory and legal compliance, creating and organizing an oral health program; working with complex patients; financial considerations in long term care, and other issues.

ADA members who register receive a reduced price of $250, and may register up to three of their nondentist team members for $150 per person. Price for nonmembers is $650.

Dentists in Maryland who participated in a state-sponsored pilot program, or a "long term care dental mini residency" hosted by the Maryland State Dental Association Foundation earlier this year, included the online course in their curriculum.

"It covered a lot of territory we may not have covered otherwise," said Dr. Doring, who is also a Legislative Affairs Committee chair of the state dental association and helped facilitate the program in Maryland.

There are 1.3 million nursing home residents that face barriers to oral care. This could be in part, Dr. Doring said, because of the unease that can come with treating older or ill patients.

"Many residents of long-term care facilities have complicated medical histories, long lists of medications and some are near end of life. The dentist may need to communicate will with family members, physicians, dietitians, speech therapists, nursing staff and social workers to determine what is the best care plan for that particular patient."

Information about working with older and ill patients is covered as one of the eight units in this course. The other units include how to access current and relevant scientific literature and establishing an environment where effective daily mouth care happens.

The pilot program in Maryland, which was supplemented by a grant from the Maryland Office of Oral Health, trained dental teams with little or no experience working in nursing homes. The program included course work and interactive lessons with Dr. Doring and Dr. Janet Yellowitz, faculty from the University of Maryland School of Dentistry.

Evaluations from the program revealed that participating dental teams "felt much more comfortable treating elderly people," Dr. Doring said.

"Half of the participants already had established a relationship with a local nursing home where they were seeing some patients regularly," Dr. Doring said, adding that the pilot program earned a Golden Apple award in 2015 for Excellence in Access to Dental Care Programs.

While it may take some study and time, working with the unique population can be personally fulfilling, Dr. Doring said. He recalls talking with his older patients about history, sports and family.

"Just to spend some time with them, I find, is very rewarding," he said.

This CE course is part of the ADA's goal to train 1,000 dentists to provide care in nursing homes by 2020.

For more information on the course or to register, visit