The P.E.P Center has recently partnered with University of Michigan student Stephanie Zigouras, RDH to improve and provide oral health resources for our friends  

Oral Health Information:

Steps to Achieving a Healthy Mouth for Special Needs Individuals:

1. Brushing (2 times a day with a soft bristle or power toothbrush)

If Individual is unable to brush themselves:

• First, wash your hands and put on disposable gloves. Sit or stand where you can see all of the surfaces of the teeth
• Use a pea-size amount of toothpaste with fluoride. Keep in mind that toothpaste can bother those who have swallowing problems. If this is the case, brush with water instead.
• Brush the front, back, and top of each tooth. Gently brush back and forth in short strokes towards the gum line at a 45 degree angle.
• Gently brush the tongue after you brush the teeth.
• Help the individual rinse with water. If they can’t rinse, give them a drink of water or consider sweeping the mouth with a finger wrapped in gauze

If the individual can brush with help:

• Try different toothbrush options to make the toothbrush easier to hold for the individual
  • A power toothbrush could make brushing easier
  • Make the toothbrush easier to hold by putting it through a tennis ball or sliding a bicycle grip on the handle
  • Help the individual brush by gently guiding their hand

            Proper brushing: http://www.adha.org/sites/default/files/7221_Proper_Brushing_1.pdf

If the individual needs you to brush for them:

• Positioning your body
  • If the individual is in a wheelchair, sit behind it.
    • Lock the wheels then tilt chair into your lap
• Stand behind the individual and lean against the wall for additional support
• Use your arm to hold their head gently against your body

2. Floss daily (curve floss towards tooth while gently going slightly below gumline)

• Any type of floss will do. If flossing is difficult try using a floss holder or floss pick

            Proper flossing: http://www.adha.org/sites/default/files/7222_Proper_Flossing_1.pdf

3. Visit a dentist at least every 6 months

• Even if the first visit (or few) is just getting acquainted and learning to brush and floss the familiarity will help with trust and comfort and improve behavior

4. Replace your toothbrush or toothbrush head every 3-4 months

 

How to Manage the Oral Health Care of an Intellectually or Developmentally Disabled Individual

• Location
  • Pick the most comfortable location for the individual. This could be the bathroom, living room, or kitchen. If area is not by the bathroom sink, allow the person to sit at a table.
  • Place the toothbrush, toothpaste, floss, and a bowl and glass of water on the table within easy reach.
  • Make sure you have good lighting.
  • Behavior
    • If behavior is difficult try the “tell-show-do” approach. Tell the individual about each step before you do it. For example, explain how you’ll help him or her brush and what it feels like. Show how you’re going to do each step before you do it. Let them hold and feel the toothbrush and floss. Do the steps in the same way that you’ve explained them
    • Be patient
      • Give the individual time to adjust to dental care and learn to trust you working in and around his or her mouth.
      • Use good body language
        • Use a positive voice and body language to communicate that you care
        • Give positive feedback frequently to reinforce good behavior
        • Establish a routine for dental care
          • Use the same technique at the same time and place every day
          • A routine can soothe fears or help eliminate problem behavior
          • Many people with developmental disabilities accept dental care when it’s familiar
          • Be creative
            • Allow them to hold a favorite toy or special item for comfort
            • Others make dental care a game or play a person’s favorite music
            • Use toothbrush modifications for the individual such as tennis balls, handle bar grips, power toothbrushes, or a Surround toothbrush© (if you are the one completing the care)

 

Practical oral health care guides

http://www.nidcr.nih.gov/oralhealth/Topics/DevelopmentalDisabilities/Documents/DentalCareEveryday.pdf?_ga=1.253098121.1458378017.1442199547

 

Surround Toothbrushes©

http://www.specializedcare.com/

 

Oral Health Nutrition:

• A healthy mouth also includes sound nutritional habits.
  • Many of the foods that help your body build strong muscles and bones also help build strong, healthy teeth and gums.
    • Dairy products provide calcium and vitamin D for strengthening teeth and bones.
    • Breads and cereals supply B vitamins for growth and iron for healthy blood, which in turn contributes to healthy gum tissue.
    • Fruits and vegetables containing vitamin C (among other important vitamins) are essential to maintaining healthy gums.
    • Lean meat, fish, poultry and beans provide iron and protein for overall good health, and magnesium and zinc for teeth and bones.
• Drinking sugary beverages such as pop, juice, sweetened tea/coffee, sports drinks, energy drinks, flavored waters, and chocolate milk increases the risk of:
  • Cavities
  • Loss of tooth enamel
  • Becoming obese
  • Developing type 2 diabetes
    • For more information visit: www.deltadentalmi.com/rethinkyourdrink

 

 

Oral Health and Overall Health are connected:

 

• Gum disease is a risk factor for heart disease, lung disease, diabetes, and premature and low birth rates.
  • Approximately 80 percent of American adults have some form of periodontal disease and the majority of them do not realize they have it, because in its early stages, it is usually painless.1

 

• Regular oral health exams can uncover signs and symptoms of osteoporosis and low bone mass, eating disorders, and HIV. 
• Regular oral health exams can help detect early stages of oral cancer

 

 

1. http://www.adha.org/sites/default/files/7228_Oral_Health_Total.pdf

 

Resources for Dental Care:

Dental Lifeline Network (DLN) - Donated Dental Services

 http://dentallifeline.org/michigan/

• The Donated Dental Program is the result of a collaboration with the Michigan Dental Association, and works to find dentists and dental labs to donate dental services to the elderly and disabled.
• The program is funded through the Michigan Department of Health and Human Services to the Michigan Dental Association.
• Serves population that is unable to afford dental treatment, permanently disabled, chronically ill or elderly
• Extensive dental work- no routine care or emergency care
• If you are interested in applying for the Donated Dental Program and live in Wayne (EXCEPT THE CITY OF DETROIT), Oakland, Macomb, Monroe, St. Clair, Lenawee, Livingston, Lapeer or Washtenaw Counties, call 1-800-850-5913.

Tooth Wisdom Project - OHA  http://www.toothwisdom.org/

●    Project by Oral Health America

●    Promotes oral health for the elderly

●    Educational tools for older adults, professionals, and caregivers

●    Links to Local services and resources

Area Agency on Aging http://www.aaa1b.org/

●    Southeast Michigan County residents

●    Resource for the elderly, adults with disabilities & caretakers:

-         Respite care                         - Medicare/aid assistance

-         Financial help                      - Assisted living locations

-         Meals                         - Low cost health care clinics

-         Transportation                    - Health workshops

Program of All-Inclusive Care for the Elderly (PACE)  https://www.medicare.gov/your-medicare-costs/help-paying-costs/pace/pace.html

●    Health service home delivery system

●    Integrated Medicare/aid financing

●    Services the frail elderly

●    Permits enrollees to live at home safely

●    Prevents institutionalization

Developmentally Disabled Treatment Fund (DDTF)

• For people born with a disability that requires the person to be managed within the Community Mental Health System assigned to a service coordinator or case manager.
• The funds are to help pay for emergency dental care or dental services beyond what Medicaid will cover. http://michigan.gov/mdch/0,4612,7-132-2942_4911_4912_6226-360522--,00.html
• Must have no other means to pay for dental treatment. Clients with private dental insurance, regardless if the insurance pays all or a portion of the claim, are not eligible for the DDTF
• Must fill out application on MDHHS website http://michigan.gov/mdch/0,4612,7-132-2942_4911_4912_6226-360522--,00.html

 

 

 

Mobile Dentistry

 

Mobile Dentists and Children's Dental Health Foundation

25882 Orchard Lake Rd., Suite 5, Farmington Hills, MI

248-442-6600       

 

• Two-chair mobile dental operatory vans fully equipped with portable dental equipment. Wheelchair accessible operatory equipped with hydraulic lift.
• Seven-chair dental operatory at Crockett Technical HS. RWJ funded full restorative dental clinics at Butzel, Carstens, Nolan, Cornerstone and Grant schools.
• Traveling program available throughout the state. In-school programs, children and developmentally disabled patients.
• Sealants, cleanings, dental exams, restorative, portable equipment

 

HM Mobile Dental Care

(313) 441-1083

1770 Culver Ave. Dearborn, MI 48124

 

• House call dental care and service. Homebound, wheelchair bound, bedridden, nursing homes, hospitalized.
• Extractions, cleanings, dentures and general dentistry for bedridden on-site; in nursing & assisted living homes, hospitals, bedside and private homes.

 

Mobile Care Group, Inc.

810-659-3135

 

• Network of dentists and doctors across Michigan offering on-site care to the homebound, those in nursing homes and assisted living centers.

 

 

Local dental offices that treat patients with special needs

 

Michigan Geriatric Dental Care    

 

Mary M. Fisher, DDS Elisa M. Ghezzi, DDS, PhD

6010 West Maple Road Suite 210, West Bloomfield, MI 48322

Office phone 248.932.8980 Voicemail 248.932.9243

Dr. Mary Fisher Cell Phone 248.760.4952 Dr. Elisa Ghezzi Cell Phone 248.358.0275

 

• Serves geriatric patients including dementia

 

 

Tri County Dental Health Council

29350 Southfield Rd. #35

Southfield, MI 48076

(248) 559-7767

 

• Low income, Medicaid, special needs
• Information & referral services, emergency treatment, dental care access programs, advocacy
• Serves Macomb, Oakland, and Wayne Counties

 

University of Detroit Mercy- School of Dentistry

(313) 494-6700

2700 Martin Luther King Blvd. Detroit, MI 48208

• Low income residents in Detroit area
• Preventative, restorative, emergency, endodontic, periodontics, orthodontic, oral surgery, and pediatric dentistry

 

Wayne County Community College District- Dental Hygiene School

(313) 943-4010

8551 Greenfield, Detroit, MI 48228

• Dental care for low-cost and reduced fees for low-income Michigan residents.
• Seniors, Children under 18, Handicapped
• Provides dental exams, tooth cleaning, fluoride treatment, dental x-rays, dental sealants and inspection, cleaning of dentures
• Costs about $10 to $12 for adults and about $8 for children under 18 years old.
• All prospective patients most complete a medical history form provided by the dental clinic which requires a list of all past and current medications.
• Appointments are available September through July at various times, Monday through Saturday from 9am to 5pm.

University of Michigan- School of Dentistry

888-707-2500

1011 N. University Ave. Ann Arbor, MI

 

• Dental school and hospital clinic. All dental services
• Underserved population
• Reduced fees, all major insurance

 

University of Michigan Medical Center Hospital of Dentistry

Oral and Maxillofacial Surgery

1500 E. Medical Center Dr., Ann Arbor, MI

888-707-2500

 

• Patients must be medically compromised or mentally impaired. Must have conditions that prevent treatment in routine dental setting. Disabled, handicapped, institutionalized.
• Payment plans

Other miscellaneous information:

Transportation services for medical appointments

 

LIVONIA DEPARTMENT OF COMMUNITY RESOURCES LIVONIA DEPARTMENT OF COMMUNITY RESOURCES - LIVONIA COMMUNITY TRANSIT

15218 Farmington Road
Livonia, MI 48154

(734) 466-2700 Main

(866) 466-2022 Toll Free

(734) 458-6016 Fax

http://www.ci.livonia.mi.us

Michigan 2-1-1

• Michigan 2-1-1 is a free, confidential service that connects you with local community-based organizations across the state offering thousands of different programs and services for people seeking answers. 
• Michigan residents can call 24/7/365 2-1-1 to find information on:
  • Arts, Culture & Recreation, Clothing, Person & Household Needs, Disaster Services, Education, Employment, Food & Meals, Health Care, Housing & Utilities, Income Support & Assistance, Individual, Family & Community Support, Information Services, Legal, Consumer & Public Safety, Mental Health & Addictions, Government & Economic Services, Transportation, Volunteer & Donation Services
  • Dialing 2-1-1 or visiting www.mi211.org gives you quick and easy access to information about services in your community. 
  • Dental services covered by Medicaid include:
    • Preventative appointments Medicaid will cover 2 prophylaxis annually
    • radiographs
    • restorative treatment

 

Videos for presentation

 

Brushing

https://www.youtube.com/watch?v=mzXRehGBEOg

Flossing

https://www.youtube.com/watch?v=N9nJxDr0L5k

Dental visit

https://www.youtube.com/watch?v=N1vCoTkY9fU