{"id":11826,"date":"2024-11-11T09:20:20","date_gmt":"2024-11-11T09:20:20","guid":{"rendered":"https:\/\/magazines.uthscsa.edu\/mission\/?p=11826"},"modified":"2026-02-04T16:36:41","modified_gmt":"2026-02-04T16:36:41","slug":"hope-for-nursing-home-residents-improving-dental-care-for-elders","status":"publish","type":"post","link":"https:\/\/magazines.uthscsa.edu\/mission\/hope-for-nursing-home-residents-improving-dental-care-for-elders\/","title":{"rendered":"Hope for nursing home residents: Improving dental care for elders"},"content":{"rendered":"

A program providing free dental treatments for Central and South Texans now educates nursing home staff to maintain the oral hygiene \u2014 and the healthy smiles \u2014 of those in their care<\/em><\/span><\/h4>\n

 <\/p>\n

The inspiration for a multimillion-dollar oral health program for nursing home residents happened long before Suman Challa, BDS, MPH<\/a>, began studying dentistry.<\/p>\n

\"Photo
Suman Challa, BDS, MPH, associate dean, School of Dentistry<\/figcaption><\/figure>\n

\u201cI was very close to my grandparents and spent a lot of time with them, so senior health care was close to my heart,\u201d said the associate dean of the School of Dentistry. \u201cWhen I began work on my master\u2019s in public health, I chose oral health in nursing homes as a topic to study.\u201d<\/p>\n

Vinaya Kundapur, BDS, MDS<\/a>, shared a similar relationship with her grandparents, which inspired her to specialize in geriatric dentistry.<\/p>\n

\u201cMy grandmother was my first patient. I made her first dentures,\u201d said Kundapur, assistant professor\/clinical in the school\u2019s Department of Comprehensive Dentistry.<\/p>\n

\u201cIt was hard on her because I didn\u2019t know what I was doing, and I was hurting her. But she told me not to stop. She said she could tolerate the pain because I was learning, and she wanted me to learn in the best way.\u201d<\/p>\n

\"Photo
Vinaya Kundapur, BDS, MDS, assistant professor\/clinical, Department of Comprehensive Dentistry<\/figcaption><\/figure>\n

Challa and Kundapur took the love, compassion and empathy they learned from their grandparents and turned it into an oral health program conducting more than 5,000 dental procedures at 58 nursing homes across South and Central Texas.<\/p>\n

\u201cWe were there to provide complete comprehensive care for patients who may not have seen a dentist in 15 to\u00a017 years,\u201d Kundapur said.<\/p>\n

HOPE, or the Holistic Oral Health Program for Elders, was a three-year program funded by a $5.7\u00a0million grant from the Centers for Medicare and Medicaid Services (CMS) that provided comprehensive dental care for nursing home residents without dental insurance. While funding for the clinical phase of the program ended in 2023, a smaller CMS grant has allowed it to transition into an education program for nursing home staff and caregivers.<\/p>\n

HOPE on the road<\/span><\/h4>\n

During its clinical phase, the HOPE program consisted of a team of 10: two dentists, two hygienists, two public health students and four dental assistants. Together they covered a wide geographic area across Bexar County. Each patient\u2019s care began with a cleaning and an assessment to determine the scope of work needed.<\/p>\n

\u201cWe would prioritize what is best first. If they had an infection, we would ensure that was taken care of,\u201d Kundapur said.\u00a0The team performed every procedure, from extracting teeth \u2014 sometimes as many as six to 10 teeth or root tips in a day \u2014 to making dentures. Many residents had compromised oral health due to dry mouth caused by medications and a history of significant medical conditions, Kundapur said.<\/p>\n

\u201cAfter scaling, we applied silver diamine fluoride as a preventive measure whenever possible. Root caries, often accompanied by periodontitis and tooth loss, were prevalent. We prioritized restoring these teeth. The only procedure not conducted was dental implants,\u201d she said. \u201cI would tell my patients that wrinkles and graying are part of aging. Graying is inevitable, but tooth loss is not.\u201d<\/p>\n

The team\u2019s daily schedule was long and subject to unexpected change. After seeing all patients at one nursing home, the team moved on to another.\u00a0Some days were more challenging than others.<\/p>\n

\u201cThere were moments when the team would go back to see a patient they saw six months ago and found the patient had passed away,\u201d Challa said.\u00a0On those days, the team members leaned on each other for support. \u201cBut we knew in that last six months we helped them and made sure they had a better quality of life until the day they passed away.\u201d<\/p>\n

Improving health<\/strong><\/span><\/h4>\n

According to Challa, the most significant outcome of the program was the difference healthy teeth made in the patient\u2019s overall physical and mental health.<\/p>\n

\u201cWhen you are improving oral health, you are improving overall health,\u201d said Challa.\u00a0He remembers one resident who isolated herself in her room with the lights turned off so other residents wouldn\u2019t visit her and see the extensive work she needed on her teeth. When the dental work was completed, \u201cshe became a social butterfly,\u201d he said.<\/p>\n

\u201cWe changed their emotional well-being and improved their overall health with better nutrition and taking away the pain they endured,\u201d Challa said. \u201cIt was transformative for them.\u201d<\/p>\n

One unexpected outcome was how the nursing home residents positively received the team.<\/p>\n

\u201cTypically, no one is jumping for joy to make an appointment with the dentist,\u201d Challa said. \u201c[The residents] were excited about making an appointment with us.\u201d<\/p>\n

Extending HOPE\u2019s impact<\/strong><\/span><\/h4>\n

With the HOPE program transition to an educational service in 2023, one dental hygienist and one dental assistant now teach nursing home staff how to maintain good oral hygiene among their patients.\u00a0The team of two meets with nursing home staff quarterly to provide themed training based on the real-life cases they saw during the clinical phase of the program to illustrate preventative measures. For instance, one training may show how to recognize infection, while another covers denture maintenance.<\/p>\n

Another goal of the program is to help nursing home staff recognize a potential dental emergency or how to prevent one. The team also provides each patient with denture care kits and oral hygiene supplies. Kundapur said that if the program had been done in reverse order, it might not have been as successful.<\/p>\n

\u201cProviding this oral hygiene education to the caregivers will help [patients] keep what we treated,\u201d she said.<\/p>\n

 <\/p>\n

\n

Assessing oral care for the elderly<\/span><\/h2>\n

65+<\/strong><\/span><\/h3>\n

According to the National Council on Aging, adults aged 65 and older are one of the fastest-growing populations in the United States.<\/p>\n

80.8 million by 2040<\/strong><\/span><\/h3>\n

The 65+ population will number 80.8 million by 2040. Yet among those in this age group, oral health is often neglected because of a lack of insurance or access to care.<\/p>\n

10,000 <\/strong><\/span><\/h3>\n

During the past year, School of Dentistry students and the school\u2019s dental practice, UT Dentistry<\/a>, treated close to 10,000 older adult patients.<\/p>\n

65%<\/strong><\/span><\/h3>\n

Of those nearly 10,000 older adult patients treated, 65% did not have insurance.<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

A program providing dental care for nursing home residents in Central and South Texas now helps educate nursing home staff to maintain the oral health of their residents.<\/p>\n","protected":false},"author":639,"featured_media":11928,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":"","_ppma_block_editor_authors":""},"categories":[1,276],"tags":[],"ppma_author":[293],"class_list":["post-11826","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","category-fall-2024"],"yoast_head":"\nHope for nursing home residents: Improving dental care for elders - Mission Magazine<\/title>\n<meta name=\"description\" content=\"The Holistic Oral Health Program for Elders, a three-year program of UT Health San Antonio funded by a $5.7 million grant from the Centers for Medicare and Medicaid Services, provided comprehensive dental care for nursing home residents in Central and South Texas without dental insurance. 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