Geriatric Jewels:
Interactive Discussion of Best Practice Gems

Pam Cushenan, RDH, MS, FSCDH
www.softsmiles.com
Objectives
•	Define knowledge and skill building methods used to prepare for and implement geriatric oral care
•	Describe soft debridement programs for older adults
•	Discuss methods used for delivery of dental hygiene services
•	List changes in access and delivery of care to clients during the pandemic

Educational Options
◦	On the Job
◦	Pros: real-life experiential learning; critical thinking skills strengthened
◦	Cons: stressful, errors common, challenging to provide maximal services
◦	Research articles
◦	In the 90s & early 2000s there were fewer resources
◦	Chalmers J, Pearson A. Oral hygiene care for residents with dementia: a literature review. J Adv Nurs. 2005 Nov;52(4):410-9. doi: 10.1111/j.1365-2648.2005.03605.x. PMID: 16268845.
◦	Greater access today: Sifuentes, A., & Lapane, K. L. (2020). ORAL HEALTH IN NURSING HOMES: WHAT WE KNOW AND WHAT WE NEED TO KNOW. The journal of nursing home research sciences, 6, 1–5.
◦	Continuing education
◦	F2F and virtual educational sessions
◦	You Tube videos
◦	Enter Geriatric Oral Health & review multiple resources
◦	Geriatric Oral Care Concentration modules/courses 
◦	Concentration modules to prepare and or enhance geriatric oral care knowledge and skills
◦	Hylife Oral Specialist Course: Angie Stone_ https://hylifeoha.com/ 
◦	Soft Smiles Oral Specialist Course: Pam Cushenan_ www.softsmiles.com 

Soft Debridement Programs 
& Caregiver Education

◦	Establish soft debridement programs for homebound, 
LTC, or other senior settings
◦	Assess client status
◦	Independent; semi-dependent; dependent
◦	Engage family member, CNA, sitter in oral assessments 
◦	Communicate recommended daily care regimen with appropriate oral aids
◦	Schedule weekly or biweekly soft debridement sessions with clients

Dental Hygiene Services/Restorative
◦	Determine type of mobile service format: portable equipment or van
◦	Purchase and set up needed items
◦	Computer, software, intraoral camera, portable x-ray equipment, & all dental supplies
◦	Contact LTC’s and other senior settings
◦	Communicate to inform clients & family members of available dental services
◦	Visit the setting to determine patient care site(s)
◦	Schedule days/times with clients

Grow your Client Base 
◦	Advertise your health care business, program, and/or care options to increase number of patients
◦	Create an effective website
◦	Utilize direct marketing with long-term-care settings, clients, and families
◦	Social marketing
◦	Word of Mouth

Cush Media* manages my Soft Smiles webpage and social media marketing
*EVOLVE TWENTY21 Conference Special: Complimentary website review
◦	http://cushmediaonline.com/ 
◦	https://www.facebook.com/Cushmedia/ 

Pandemic Considerations
◦	Older adults are at higher risk for respiratory infections, such as COVID-19 or SARS-CoV-2
◦	Depending on the state, there may not yet be access to clients
◦	Prescreen protocols
◦	Temperature taken upon arrival
◦	Standard precautions plus additional products ↑ infection control efficacy

Aerosol reduction & Protection products
◦	Air Cleaners
◦	HEPA filtration
◦	Trap 99.7% of particles ≥ 3 µm in size
◦	Surgically Clean Air: Jade air purification (SCA5000C)
◦	Cleans the average operatory air every 2 minutes

◦	Faceshields
◦	Ultralight Optics
◦	Lightweight, adjustable, flip-up feature, comfortable
◦	One-use disposable or more durable multi-use type shield

Aerosol reduction & Protection products
◦	Masks
◦	Approved lists of N95 & KN95 masks are found 
in the CDC and FDA
◦	N95 (appropriate fit & seal test 
for effective use) 
◦	KN95 
◦	Level 3 surgical masks 
◦	dual layer; may use Lv 2 as outer mask

Aerosol reduction & Protection products
◦	High Volume Evacuation
◦	Intraoral evacuators
◦	PureVac HVE System
◦	Dentsply Sirona
◦	Aerosol reduction by 81-94%
◦	Fluid-based evacuation
◦	Nu-bird HVE System (8mm bore opening for maximum evacuation)
◦	Re-Leaf System
◦	Extraoral vacuum aspirators (EVOA)
◦	PAX2000 or Maxvac MAXVAC-1000 Chairside Extraoral 
Dental Suction System. 3 Step Filter
◦	Place 2-8 inches above oral cavity
◦	Spatter reduction by 90%
◦	Significant reduction in microbial bioload

Aerosol reduction & Protection products
◦	IoRinse Molecular Iodine:  https://www.physicsforceps.com/index.php?route=product/product&product_id=513 
◦	Nu-bird HVE mirrored suction: To Order call 425-584-7206 & mention the promo code “SLVRAVN” for a free $40 gift with your order; https://www.nu-bird.com
◦	PAX2000 Extra Oral Evacuation: https://tricountydental.com/product/pax2000-extraoral-dental-suction-system/ 
◦	Optim 1 wipes: https://www.scican.com/us/products/cleaners-disinfectants/optim-1/ 
◦	Ultralight Optics face shield: https://ultralightoptics.com/ Enter special code: dy for 10% in discount code window when ordering
◦	Young Splatter Guard disposable prophy angles: https://info.youngdental.com/splatterguard   

Products
◦	Aseptico Portable Dental Equipment: https://aseptico.com/product-category/portable-dentistry/portable-delivery-systems/
◦	Crest Oral-B Electric Brush: https://shop.oralb.com/oral-b-pro-500-rechargeable-electric-toothbrush/
◦	Crosstex DentaPure Independent: https://www.crosstex.com/dentapuretm-dp365b-independent-water-bottle-cartridge-97
◦	MouthWatch TeleDent: https://www.mouthwatch.com/intraoral-cameras/
◦	VOCO Remin Pro: https://www.voco.dental/us/products/preventive-care/protective-dental-care/remin-pro-not-available-in-canada.aspx

Products 
◦	Open Wide Mouth Prop: https://specializedcare.com/search?type=product&q=open+wide+mouth+prop
◦	Universal cuff: (strap w/pocket secures TB to hand) Maddak, Inc (800)443-4926
◦	Universal Cuff: www.grovergear.com (866)666-9680

Summary
◦	There are multiple pathways to prepare for & implement geriatric oral care
◦	Establishing access to a senior oral care program is key to client comfort and welfare
◦	New technologies and advances in infection control improve the safe delivery of necessary preventive and restorative dental services

Thank YOU

Pam Cushenan, RDH, MS, FSCDH
SOFT SMILES, LLC
softsmilesinfo@gmail.com 
www.softsmiles.com 

Please email any remaining questions