Oral Health Program

SOWELA Technical College

By: Kaylee Dreckman, Anna Rusnak, Tori Touchet, and Scott Sonnier

NEEDS ASSESSMENT

A. General Data

Description of Site:

 SOWELA is a technical community college that offers associate degree, technical diploma, or
certificate awards in 23 different programs. SOWELA is located at 3820 Senator J. Bennett
Johnston Ave. Lake Charles, LA 70615. SOWELA has been opened since 1938 and is
committed to access and diversity, excellence in teaching, student success, student centered
environment, faculty and staff development, program relevance, and community
partnerships. It is accredited by southern association of colleges and schools commission on
colleges (SACSCOC). This agency strives to offer the best programs to their students. This
site is funded by student tuition, government grants, and student loans. (1)

Description of Target Group:

 Our target group is the future patients in hospitals, nursing homes, and clinics. We will
reach the target populations by teaching our clients, first year students of the LPN program
attending SOWELA. We will be teaching 38 students at SOWELA in Lake Charles, LA and 21
students at a remote site in Jennings, LA.

Description of Staff Population:

 The chancellor is the head of the community college. There are four vice chancellors. The
vice chancellor for academic affairs is the head of the school of nursing and allied health.
The program that we will be associated with is instructed by the dean of the school or
nursing and allied health. We will be in contact with Kimberly Eaves, MSN, RNC, the practical
nursing program coordinator. (1)

Description of Services Provided:

 This practical nursing program is designed to prepare the students to become a licensed
practical nurse. The nursing students attend daily classes along with supervised clinical
activities at local hospitals, nursing homes, and clinics. These students must follow the
Louisiana state board of practical nurse examiners. The students are required to complete a
minimum of 40 hours of clinical activities. The students must pass the National Council of
State Boards Licensure Examination (NCLEX) for practical nurses. In the future SOWELA
plans on offering a Registered Nursing program.
 Other Pertinent Data:

 The Lake Charles, LA water fluoridation ranges from .18-.26 ppm. (2) The recommended
fluoride intake is 0.7 mg/L (ppm), so these residences may need fluoride supplements.

B. Information Related to Dental Health

Services Provided:
 This LPN program normally provides basic level oral health course work for their students.
However, our group will be providing dental patient education topics for this freshman LPN
class of 59 students, and we will be taking over the dental course work for the instructors.
Due to lack of dental resources on campus, we will be providing dental supplies for
demonstration and education purposes.

C. Dental Health Status

 Dental Caries
- More than 1 in 4 (27%) adults in the United States have untreated tooth decay. (4) A
research was done on hospitalized patients to assess their oral care. Here are some
results from the study done. Caries were associated with smoking and poor oral
hygiene. Hospital length of stay and age were associated with increased dental
plaque index and gingival index. The majority of hospitalized patients did not
present satisfactory oral hygiene. Caries and periodontal diseases are associated
with health behaviors. Increased time length at hospital could increase gingival
inflammation and dental plaque accumulation. (3) This is why it is important for
nurses to have a better understanding of oral care to better assist their patients.
 Periodontal Disease
- Periodontal disease is a problem in patients in long term care facilities and hospitals
due to lack of oral hygiene. The major risks for tooth loss are tooth decay and gum
disease that may increase with age because of problems with saliva production;
receding gums that expose “softer” root surfaces to decay-causing bacteria; or
difficulties flossing and brushing because of poor vision, cognitive problems, chronic
disease, and physical limitations. (7)
 Oral Hygiene
- Good oral health is an important aspect of quality of life, even for the elderly. Teeth
are important for chewing, speech and appearance. The concept of care involves
not only caring for the sick, but also taking preventive measures to preserve good
overall health. Daily oral care for the dependent elderly who cannot manage it
themselves is expected to be performed by healthcare professionals. (5) “To
improve oral care, oral care should be included in nurse’s work schedules as a more
 highly prioritized task, and nurses’ knowledge needs to be enhanced. A network of
activities at all levels is needed to implement oral care in nursing care.” (3)
 Oral Cancer
- Oral cancers are most common in older adults, particularly in people older than 55
years who smoke and are heavy drinkers. People treated for cancer who have
chemotherapy may suffer from oral problems such as painful mouth ulcers,
impaired taste, and dry mouth. Nurses are the caregivers for these patients while
they are in the listed facilities and it is important for them to know how to care for
their patients including oral health. (9)
 Added Information
- Associations between oral and systemic health, should be incorporated into oral
health education programs for nursing staff. Fifteen studies have shown daily oral
hygiene decreases the risk of aspiration pneumonia in hospitalized patients and
LTCF residents. Discussing that there is an increased risk of aspiration pneumonia in
those with poor oral hygiene, will open their eyes to better understand the
importance of oral health since pneumonia is a significant predictor of death in
nursing homes and is responsible for a large proportion of hospitalizations. (6)

Goal: To increase oral health care in hospitals, nursing homes and clinics by educating nursing students
and help them improve their knowledge on preventative dentistry.

Objectives:

 The LPN students will be able to differentiate between normal and abnormal oral
conditions.
 The LPN students will be able to define plaque, demonstrate proper brushing technique, and
demonstrate correct flossing technique to properly remove plaque.
 The LPN students will be able to identify different perio-aids and what each is used for.
 The LPN students will be able to demonstrate proper cleaning and care of dentures and
partials.
 The LPN students will be able to identify what beverages are high in sugars and bad for
patient’s teeth.
 We will improve our clients oral care knowledge by 20%.

Rationale for Program:

This oral health program is directed towards future LPN’s that will be working in nursing homes,
hospitals, and clinics. We are educating LPN’s as our clients who will be reaching our target population.
There is an increasing amount of dental decay and periodontal disease in patients in care facilities due
to a lack of oral hygiene. Oral health in hospitals, clinics, and nursing homes is often overlooked by
nurses. The mouth is the gateway to the body and it is very important to educate others on oral health
and how to prevent disease. Our target population deals with issues such as illness, mental illness,
dementia, and Alzheimer’s. These issues disrupt our target population’s oral health because they are
less likely able to care for themselves. (7)

There has been a dramatic improvement in oral health over the past 50 years, meaning that
older individuals are keeping their natural teeth longer. Adult Oral Health Surveys have shown a decline
in the percentage of older people with no natural teeth from 78% in 1978 to only 24% in 2009.
Maintaining one’s oral health is important for psychosocial well-being. Several studies have shown the
negative impact of oral diseases on older peoples’ oral health-related quality of life (8). It is important to
educate future LPN’s so they can give the proper oral care needed to their patients.

A nursing staff educated on oral health has shown to improve plaque scores of Long Term Care
Facility Residents. Providing information of the importance of daily oral hygiene may increase the
chance that the nursing staff will provide residents with the help they need to perform daily oral
hygiene. Research suggests that nearly 80% of LTCF residents need help with daily oral hygiene care. (6)

Nurses employed in LTCFs are required to examine the oral cavity during resident admission
assessment. Research shows that oral assessments are more accurate when provided by nurses who
have attended dental in-service training. Studies have also demonstrated that dental education
programs for nursing staff in LTCFs improve oral health outcomes. Thus, oral health education has the
potential to help nursing homes enhance the quality of care for residents, while improving compliance
with federal mandates for providing daily oral hygiene care. (6)

Program Design:

 Activities :
o The purpose of our Oral Health Program is to teach future LPN’s the possible cause
contributing to a systemic disease, what to look for in the oral cavity, how to properly
clean the oral cavity and dentures, and nutritional information for a cleaner, healthier
oral cavity. We will be attending SOWELA in Lake Charles, LA four times in two weeks to
teach the LPN students. We will be using the following to help with our presentations:
 Pre/Post Test
 Hands on demonstrations
 Power point hand outs
 Brochures
 Nutrition Game
 See lesson plans for specific daily activities
 Constraints and Alternative Strategies
o We are not teaching our target population, we are relying on our clients to get our
target population the knowledge and proper care. The alternative to this would be to
teach patients directly at nursing homes, hospitals, and care facilities.
 o The designated time would not be enough to cover all the topics. Alternatives:
Brochures about oral health will be given to the client population to serve as a guide and
reference in the future.
 Resources:
o Power points / Handouts
o Models/Typodont
o Denture brushes/boxes
o Perio-Aids
o Sugar samples of different beverages
 Budget:
o Pre/Post Test – Provided by presenters
o Brochures – Donations/ Provided by presenters
o Power Point Handouts – Printed by presenters, $30/session
o Toothbrushes – Provided by presenters
o Toothpaste – Provided by presenters
o End tuft brush – Provided by presenters
o Interdental brush – Provided by presenters
o Floss holder – Provided by presenters
o Supra floss – Provided by presenters
o Denture brushes/Boxes – Provided by presenters
o Denture tabs - $10
o Biotene Mouth rinse - Provided by presenters
o Estimated total cost = $130
 Timetable:
o Phone/Email conversation with director of the nursing program to discuss pertinent
information
o Session 1: Thursday March 8th, 2018 (11:15am – 1:00pm)
o Session 2: Tuesday March 13th, 2018 (11:30am-12:00pm)
o Session 3: Wednesday March 14th, 2018 (11:30am-12:00pm)
o Session 4: Thursday March 15th, 2018 (11:30am-12:00pm)

Evaluation:

 Formative:
o Pre-test will be given at session one and post test will be given at session 4. These tests
will allow us to form quantitative and qualitative data to test our projects efficiency, and
the expected improvement in oral care knowledge is 20%.
 The LPN students will be able to differentiate between normal and abnormal
oral conditions.
 The LPN students will be able to define plaque, demonstrate proper brushing
technique, and demonstrate correct flossing technique to properly remove
plaque.
  The LPN students will be able to identify different perio aids and what each is
used for.
 The LPN students will be able to demonstrate proper cleaning and care of
dentures and partials.
 The LPN students will be able to identify what beverages are high in sugars and
bad for patient’s teeth.
 Summative:
o A pre and post test will be given and evaluated to assess the knowledge of the future
LPN students to see if their oral health knowledge increased by 20%.

Appendix:

 Pre-test, post-test and lesson plans

Session One

Lesson Plan

 Introduction
o This lesson is focused on freshman nursing students. The goal of the lesson plan is to
educate the importance of head and neck/intra oral exams, discuss pathological
findings, and demonstrate oral cancer screenings.
 Objectives
o Psychomotor:
 The nursing students will be able to demonstrate proper head and neck/intra
oral examinations.
o Cognitive:
 The nursing students will be able to discuss the importance of the head and
neck exam.
 The nursing students will be able to identify signs of pathological findings.
 The nursing students will be able to identify signs of oral cancer.
o Affective:
 The nursing students will be able to assess the patient’s needs through visual
inspections by performing head and neck exam and intra oral exams.
 The nursing students will be able to assess patient’s oral cavity by noticing
abnormal findings vs. normal findings.
 Content
o Give the nursing students pamphlets with information about oral cancer screenings for
references when assessing patients.
o Demonstrate how to properly give a head and neck and intra oral examinations.
 o Give the nursing students visual aids and brochures on head and neck exam for
reference when distributing knowledge of cancer screening to patients.
 Method of Teaching
o Discussion and demonstration with nursing students over oral health topics.
 Evaluation and Assessment
o Questions and answers of the lesson taught.

This lesson will be conducted by four dental hygiene students at SOWELA Technical Community College
in the nursing facility.

Session Two

Lesson Plan

 Introduction
o This lesson is focused on the freshman LPN nursing students. The goal of this lesson is
to educate the nursing students on what plaque is, the importance of removing plaque,
and how to effectively clean the oral cavity.
 Objectives
o Cognitive:
 The LPN students will be able to define what plaque is and describe the
importance of removing it.
 The LPN students will be able to describe the correct brushing and flossing
techniques.
o Psychomotor:
 The LPN students will demonstrate the correct brushing and flossing techniques
by the end of this session.
o Affective:
 The LPN students will be able to discuss different perio-aids with their patients.
 The LPN students will assess what perio-aid is best for different situations.
 Content
o Power point presentation for students at SOWELA and at their remote site as well.
o Use visual aids, like flip books, to explain what plaque is and how it forms. Explain if
plaque is not removed daily that it will become hard and the patients will not be able to
remove it by brushing and flossing.
o Demonstrate the proper brushing and flossing techniques using typodonts,
toothbrushes, and floss.
o Pass around different perio-aids for the students to look at, and show pictures of
different areas in the mouth each perio-aid may be best used.
 Method of Teaching
 o Discussion and demonstration with the home health aides and perio-aids.
 Evaluation and Assessment
o Questions and answers of the lesson taught.

This lesson will be conducted by four dental hygiene students at SOWELA Technical Community College
in the nursing facility.

Session Three

Lesson Plan

 Introduction
o This lesson will be taught to the freshman LPN at SOWELA technical community college.
The goal of this lesson is for the LPN students will be able to demonstrate proper
cleaning and care of dentures and partials. The students will gain knowledge on
different types of dentures and partials.

 Objectives
o Psychomotor:
 The students will demonstrate proper denture cleaning technique using denture
models, brushes and solutions.
o Cognitive:
 The students will be able to explain proper denture cleaning techniques to
patients and colleges.
o Affective:
 The students will discuss and recognize proper and improper techniques that
patients may use to clean dentures.
 Content
o We will be giving a presentation using visual aids such as a power point and video about
proper denture cleaning techniques. The power point will include photos of different
types of dentures and partials. The power point will also include common oral findings
in patients that wear dentures and partials.
o We will use visual aids by having examples of dentures, partials, dentures brushes,
cleaning tabs, denture adhesive, and denture boxes to pass around for the students to
practice with.
o We will hand out a copy of this power point to the students to keep and follow along
with the presentation.
 Method of Teaching
o Presentation, demonstration and discussion.
 Evaluation and Assessment
o The pre/post test will help determine the effectiveness of this presentation. We will
answer any questions the students have after the presentation.
This lesson will be conducted by four dental hygiene students at SOWELA Technical Community College
in the nursing facility.

Session 4

Lesson Plan

 Introduction
o This lesson is focused on the LPN students. The goal of the lesson is for them to be able
to provide nutritional counseling to their patients.

 Objectives
o Cognitive:
 The LPN students will be able to identify what beverages are high in sugar and
bad for the patient’s teeth.
 The LPN students will be able to explain what the neutral pH is in the oral cavity.
 The LPN students will be able to differentiate between healthy and non-healthy
snacks.
 The LPN students will have knowledge on the impact that the combination of
beverages and food one consumes has on dental caries.
o Affective:
 The LPN students will be able to provide nutritional counseling to their patients
through skills and lessons previously discussed.
 Content
o Give LPN’s post-tests
o A PowerPoint will be used in this session.
o Answer any questions the students have.
o Play a nutritional counseling game.
o Fanta orange drink, red bull, sweet tea , coke, milk, and apple juice.
o Sugar bags with the correct measurements of sugar to show the students the amounts.
 Method of Teaching
o Discussion and demonstration with the LPN students over nutritional counseling.
 Evaluation and Assessment
o Post test
o Address any questions the students may have

This lesson will be conducted by four dental hygiene students at SOWELA Technical Community College
in the nursing facility.
 References

South West Louisiana Technical Community College, (2018, February 6). Retrieved from
http://www.sowela.edu (1)

Lake Charles, LA Water Fluoridation. (2018, February 26). Retrieved from

http://www.cityoflakecharles.com/egov/documents/1494952302_08414.pdf (2)

Neto, A., De Paula Ramos, S., Sant'ana, A., & Passanezi, E. (2011). Oral health status among
hospitalized patients. International Journal Of Dental Hygiene, 9(1), 21-29.
doi:10.1111/j.1601-5037.2009.00423.x (3)

Dye BA, Thornton-Evans G, Xianfen L, Iafolla TJ. Dental Caries and Tooth Loss in Adults in the United
States, 2011-2012. NCHS Data Brief, no 197. Hyattsville, MD: National Center for Health
Statistics; 2018. (4)

Lindqvist, L., Seleskog, B., Wårdh, I., & Bültzingslöwen, I. (2013). Oral care perspectives of
professionals in nursing homes for the elderly. International Journal Of Dental
Hygiene, 11(4), 298-305. doi:10.1111/idh.12016 (5)

VanArsdall, P. S. (2016, May 01). Improving the Oral Health of Long Term Care Facility Residents.
Retrieved March 3, 2018, from http://decisionsindentistry.com/article/improving-oral-health-
long-term-care-facility-residents/ (6)

Oral Health. (2017, October 23). Retrieved February 26, 2018, from
https://www.cdc.gov/oralhealth/basics/adult-oral-health/index.html (7)

Muirhead, V. E., Marcenes, W., & Wright, D. (2014). Do health provider–patient relationships
matter? Exploring dentist-patient relationships and oral health-related quality of life in older
people. Age & Ageing, 43(3), 399-405. (8)

National Cancer Institute. Surveillance, Epidemiology, and End Results (SEER) Program. (N.D.)
SEER Stat Fact Sheets: Oral Cavity and Pharynx Cancer
website. http://seer.cancer.gov/statfacts/html/oralcav.html. Accessed March 7, 2018. (9)