MDS Alert

There's finally some new guidance on how to best deal with residents' dentures, and documentation, like always, will be key.

Make sure your facility has a written policy on about dentures, says Maureen Kelly, Rn, Don-Ct, senior clinical consultant at LW Consulting Inc. in Harrisburg, Pennsylvania, in a recent webinar.

Your policy should specify your facility's responsibilities, in terms of replacement, for lost or damaged dentures. Your facility's new denture policy should also list the specific steps for documenting loss or damage, and how to determine whether the fault lies with the resident or the facility. The new regs require that facilities conduct an investigation into the loss or damage of dentures, just as the facility would need to investigate other allegations of wrongdoing.

Beyond an investigation, you or a team member should also:

Notify the resident's physician

Make sure the resident and/or the resident's responsible party are aware of the damage or loss

Denture replacement can be a fairly long-term process, usually three to six months. Help keep the resident as comfortable and nourished as possible with these tips, Kelly says:

• Order a speech therapy evaluation; a resident who doesn't have teeth won't be able to speak as clearly and may have difficulty chewing or swallowing.
• Alert the facility nutritionist and dining services; a resident whose capacity to chew or swallow has changed will probably need a meal adjustments. » »
• Think about how the patient is feeling; she might be self-conscious and not want to socialize or participate in activities. Alert your activities staff team members so the resident can still feel involved, even if she chooses to withdraw.
• Get your social worker involved in the coordination of dental care and services.

Remember: Your facility must notify a dentist or schedule an appointment to have dentures fixed or replaced within three days. If you don't make a referral within three days, your facility must have documentation to support your care for the resident while he waited for dental care, as well as documentation as to the cause of the delay.

Don't forget to alert other nonmedical team members about your new dentures policies, Kelly says. Residents' families or responsible parties may approach your facility's business office with questions about denture predicaments; make sure your colleagues can provide accurate information about your current policies and procedures to avoid further confusion.