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From Trisha's Desk Trisha E. O’Hehir, RDH, MS, Hygienetown Editorial Director

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– by Trisha E. O’Hehir, RDH, MS, Hygienetown Editorial Director

No one wants to think about it, but you could end up in a nursing home one day due to either an accident or complex medical issues requiring others to care for you. Lawyers urge people to have a signed advanced health-care directive, consisting of two forms. One is a living will, specifying what healthcare actions be taken if through illness or injury you become unable to make those decisions yourself. The other form is a power of attorney or health-care proxy specifying who will make your health-care decisions if you can't.

Missing from these directives is a specific oral health-care directive. In the five wishes document, a comprehensive living will from the Aging with Dignity Organization, oral health falls under general grooming, not health. But since oral health is so important and needs to be addressed every day through both oral hygiene and diet, a specific oral health directive should be in place as well. What specific directions would you like caregivers to follow to maintain your oral health? Or, as some Townies on Dentaltown suggested for nursing home patients, would you opt for full-mouth extractions? They weren't suggesting it for themselves, but did for nursing home residents. What if one day you become a nursing home resident? Do you think those Townies would still want full-mouth extractions for themselves?

In 1993, this became a reality for Irene Woodall, RDH, PhD, a leader and visionary in the dental hygiene profession. While skiing in Colorado she suffered an aneurysm. With speedy medical care, she was rushed to the hospital and underwent brain surgery that prevented a more intense stroke that would have taken her life. Instead, she suffered severe brain damage taking away her short-term memory and severely affecting her cognitive and physical abilities. Irene is now confined to a wheelchair and requires care around the clock.

In the midst of all the medical care needed to deal with the stroke and rehabilitation, her dental care was overlooked. Her daughters are overseeing her care at a long-term care facility in the Chicago area and were shocked to find that their mother, a consummate dental hygienist, now has severe dental disease! To cover the extensive dental costs ahead, they created the Irene R. Woodall Special Needs Trust from which donations will be used for Irene's oral health-care needs.

Had Irene had an oral health-care directive in place when she suffered the stroke and subsequently was moved to a long-term care facility, her oral health and diet would have been addressed the way she wanted, not overlooked because of other issues. Oral health will impact general health, so it shouldn't be overlooked in any situation.

What would you want done for your oral health on a daily basis if you suffered a stroke and were confined to wheelchair and unable to perform your own oral hygiene? I know what I would want – five exposures to xylitol every day, MI Paste morning and evening, twice-daily brushing with the 30 Second Smile toothbrush using baking soda to keep the pH of my saliva up, tongue scraping, interdental cleaning with either the Sunstar Soft Picks or flossing with water. I'd also specify the diet I want.

Write out your own oral health directive today just in case something unforeseen happens one day and write your directive with the hope that it will never be needed.

Inside This Section
114 Perio Reports
118 Message Board: Tongue Stud Damage – A Case Study
120 Profile in Oral Health: Townies Doing Research
124 OCD Feature: Facing Our Fears
126 Message Board: Increase Doctor's Production
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