Senior lecturer in geriatric dentistry at the University of Western Australia Dr Clive Rodgers says nursing homes across Australia are seriously neglecting the dental health of their patients.
The ABC warns the graphic images of medical conditions in this report may be distressing to some viewers.
Link: Original source including video
Australian Broadcasting Corporation: Broadcast: 04/12/2008 (Reporter: Suzanne Smith)
TONY JONES, PRESENTER: Tonight Lateline reveals the hidden suffering of elderly Australians across the country - victims of aged care homes that are letting them literally rot away, at least when it comes to their dental health.
A senior dentist has told the ABC the state of dental care in many nursing homes is appalling, and in some cases tantamount to abuse and neglect.
Dr Clive Rogers says nursing homes are passing accreditation tests even when their residents' mouths and teeth are so ravaged they risk serious illness or premature death.
Lateline's Suzanne Smith has this special report. And a warning, the graphic images of medical conditions may be distressing to some viewers.
DR CLIVE ROGERS, SENIOR LECTURER, UNIVERSITY OF WESTERN AUSTRALIA: I've just come to have a look at your mouth, is that OK?
SUZANNE SMITH, REPORTER: Clive Rogers is doing his rounds at a nursing home in Perth; a routine he has done for the last 12 years.
He is getting ready to examine a woman with dementia.
DR CLIVE ROGERS: There's quite a lot of gear I've got here to get so it won't be very long.
Let's have a little bit of light.
This is a fairly classic mouth. What we're looking at here is... there's massive amounts of food debris and plaque, which is very old.
And just down in the front here... and there's large lesions and some of them are small, relatively, occupying maybe one tenth.
Some have occupied 30 per cent of the tooth; some have just completely eaten through the top of the tooth above the gum.
SUZANNE SMITH: As Dr Rogers examines further, he is not shocked by what he sees; for him it is a typical mouth of a nursing home patient.
DR CLIVE ROGERS: This is a fairly typical mouth of what I see. I see actually worse than this sometimes; I see better than this.
In this mouth I'm predicting that there's five abscesses. Though I have on one particular chap seen 19 tooth roots, and it appeared that nearly half of them were actively draining pus into the mouth.
SUZANNE SMITH: Dr Rogers says untreated dental abscesses could become septic and lead to major infection.
But what most disturbs him is that some patients are obviously in pain.
DR CLIVE ROGERS: The thing that disturbs me most is seeing someone who is in pain. Yes, having pus draining into their mouth, abscesses, they disturb me.
The whole aspect of the neglect and the whole aspect that this is not widely known amongst the population, Australia at large, that mouths that I see, these terrible mouths, exist everywhere all over Australia.
SUZANNE SMITH: So concerned by what he saw, Dr Rogers has put together a library of photos to show the extent of the problem.
He has also conducted his own national survey of 18 visiting dentists who all have experienced working in nursing homes across all states and territories.
DR CLIVE ROGERS: Out of those 18 people, 89 per cent of them said that they didn't believe that the standard was being met.
I will go in and I will look at the in house dental reports, and some reports done by other government bodies. I will totally disagree with what's been written down.
SUZANNE SMITH: He is concerned accreditation authorities are ignoring the Government's legislated standards that require nursing homes to ensure daily maintenance of oral and dental hygiene.
DR CLIVE ROGERS: All the nursing homes I see should not be passing their accreditation. And from the survey that I did, that seems to be the consensus around Australia.
SUZANNE SMITH: Of great concern too is the link between dental health and general health. Periodontal disease can lead to cardiovascular illness.
Untreated caries and dental abscesses can in some cases lead to pneumonia, especially if patients inhale stagnant food or puss from infections.
Dr Rogers says some of the neglect could be considered a form of abuse.
DR CLIVE ROGERS: Neglect as a form of abuse, yes, I have to say it is, especially when the problem is recognised or seen, and then nothing is done about it.
SUZANNE SMITH: Dr Rogers lodged complaints with the accreditation authorities and the Commonwealth Department of Health and Ageing, who have rejected his claims.
Minister For Ageing, Justine Elliot, has asked Dr Rogers to send his complaints to her directly.
JUSTINE ELLIOT, MINISTER FOR AGEING: I would encourage him to put forward complaints and issues he has to the complaints investigation scheme or to forward them to me personally, because, as I say, anyone raises any issues in relation to any matter to do with the nursing homes, whether it's about health, safety and wellbeing, these will be investigated.
SUZANNE SMITH: Minister Elliot announced a strengthening of 44 legislated standards that govern nursing homes.
SUZANNE SMITH: I'm also getting all of those standards assessed. And since I've become minister I've looked at ways of strengthening our age care standards and accreditation agency, strengthening their standards as well.
SUZANNE SMITH: Dr Rogers says immediate action needs to be taken to ensure the daily care of oral and dental health in your nursing homes.
Source: ABC - Lateline - Suzanne Smith
