The PrevMED OHM® Program is a multi-step, fully integrated program which includes the on-site delivery of clinical services combined with regular communication, oral care and prescription products, and staff training. The emphasis of this Program is to improve the overall health and well-being of the resident by ensuring the oral cavity is as healthy as possible. The OHM® Program is designed to reduce and eliminate harmful bacteria and infection from the oral cavity which, when left untreated, can contribute to many systemic illnesses.
Our focus is on delivering preventative medicine. We improve oral health as a means to improve overall health. The OHM® is not a cosmetic program. Healthy teeth are not always attractive and attractive teeth do not insure health. Research has shown that after approximately 30 days the bacteria in the mouth becomes more toxic, increasing the chances of developing cavities, bone loss and other oral infections. The OHM® Program is a monthly plan to remove harmful bacteria consistently, thereby preventing downstream health complications and additional healthcare costs.
By working with the facility and the patient’s medical team, we can decrease pain and discomfort. We will teach the residents and staff the importance and techniques of good oral health. Together we can contribute to improving dignity and quality of life for the residents.
The 12-month OHM® Program is delivered by a licensed, credentialed local Dentist and Registered Dental Hygienist (in states that provide for RDH service delivery). The same compassionate PrevMED clinician will visit your facility monthly (sometimes twice per month, depending on the patient census) in order to build rapport, trust and comfort with your residents.
Initial Dental Assessment
This determines the need for and resident’s ability to accept professional dental care. A visual exam is done by a licensed Dentist to identify any abnormalities around the face or head, any suspicious lesions in the oral cavity, and the presence of dental disease, plaque and calculus. If an oral cancer biopsy is indicated, PrevMED will begin to process forms to administer the tests. At this appointment the Dentist will prescribe the patient’s recommended level of care. This must be completed before any services can begin. A re-assessment will be performed as required.
Comprehensive Oral Exam (COE)
At the COE the Dentist will diagnose, determine the severity of disease and recommend an appropriate individualized treatment plan for each patient. During the COE, the Dentist will examine the patient’s medical records to assess the need to consult with his/her physician about any condition that may be a deciding factor as to their treatment to restore oral health. At this appointment the Dentist will determine which prescription and oral care products should be used to best meet the patient’s needs.
The COE includes a full set of x-rays, if indicated. The goal is to obtain an individual picture of every tooth. This will show bone loss, level of decay, calculus below the gum line and any abnormal periapical changes at the tooth root tip. The x-rays are taken only to the extent that a resident can tolerate the procedure. If a patient is aggressive, intolerant or unable to control the muscles required for x-rays, we will clearly document this on the patient’s medical records.
Prophylaxis and Full Mouth Debridement
The RDH/Dentist will perform a either a prophylaxis or full mouth debridement each month. The prophylaxis is a polishing procedure that is done with a rotary instrument which removes plaque, most extrinsic stain, and aides in smoothing the enamel surface of the tooth. The same instrument may also be used for the application of oral infection control products, including a monthly application of fluoride varnish which is placed with the applicator enclosed with the dose. A full mouth debridement is the mechanical removal of calculus and plaque with the goal of removing harmful bacteria. In the nursing home environment it often requires more than one visit to remove all the harmful bacteria. The clinician will determine each month if a debridement is necessary.
Intermediate Restorative Material
PrevMED uses Intermediate Restorative Material (IRM) to provide a sedative filling that reduces pain from inflamed or irritated pulp. This non-invasive treatment has been found to be effective in arresting decay for patients living in skilled nursing facilities.
Patients with Dentures
Dentures are provided as a benefit to certain policy holders. Residents must be pre-qualified for the Denture Program by our Dentist and meet certain payment requirements.
Read our Denture Program Policy for complete details
Soft Chair-Side Relines – The Dentist/RDH will insert a soft material for ill fitting dentures to improve comfort and retention.
Denture Marking – We will mark the patient’s initials on their denture(s) after it is ultrasonically cleaned in an attempt to avoid cross contamination. The surface is etched with a pad, marked with a pen and two coats of clear sealing liquid are applied.
Periodic Oral Examination
During the monthly visit, our RDH/Dentist will look for signs of infection or potential problems, monitor the progress of treatments and, where needed, check the fit and condition of dentures. As an oral cancer screening, our clinician is trained to visually inspect all oral tissue, including the tongue, cheeks, palate and floor of mouth for anything suspicious every time they enter the oral cavity. The clinician will also do a thorough cleaning, flossing and swab gums during this procedure.
Rx Infection Control Products
These products are prescribed by the Dentist for use according to the individual needs of the resident. Examples of these products are 10% Iodine rinse, doxycycline (a periodontal disease preventative), chlorahexidine or Peridex anti-microbial rinse (to treat gingivitis), antibiotic therapy, MI Paste (recaldent for mineralization and tooth sensitivity) and xylitol products (a cavity and dry mouth preventative).
Oral Cavity Home Care Products
Each patient is given his/her own oral care product kit when they enroll in the OHM® Program. The kit contains the daily care products recommended by the Dentist at their initial COE. For daily use the resident will receive one battery-operated toothbrush every six months, a manual toothbrush, anti-bacterial toothpaste and wipes. Patients requiring denture care products will receive a denture brush, cleaning tablets, adhesive and a cup for overnight soaking. If the patient suffers from dry mouth, their kit may contain medicated mints, xylitol products or mouth wash in a spray bottle and medicated gels to soothe gums. The products are replenished during each monthly visit, as needed.
Patient and Family/RP Communication
Each month during their visit the RDH/Dentist will work with the resident to instruct them on proper oral hygiene care and techniques, according to their individual abilities. After the visit, the clinician will attempt to call, or send a note to the Family/Responsible Party to discuss the services and answer any questions about their family member’s oral care. Additionally, PrevMED will host Family Nights or attend Family Council Meetings during the year in order to promote and discuss the PrevMED OHM® Program and answer any questions.
Facility In-Service Training
In-Service training is offered to the facility staff. The goal of these sessions is to motivate and teach CNAs to help residents with daily compliance and educate them in their thinking about the harmful effects of bacteria in the mouth. Many have never considered oral hygiene as wound care. They don’t realize that debris left in the mouth harbors e.coli, s. pneumonia and h. influenza, for example, that can be aspirated, contributing to the severity of a variety of systemic diseases.
In addition to the OHM® Program services, PrevMED provides for Dentures, On-site Extractions and Emergency Response to Acute Pain and Restorative Care. Additionally, in certain areas, PrevMED offers a Portable Dental Care van to provide services for all residents’ oral healthcare needs. These programs have certain qualifications, limitations and guidelines. Please read the guidelines carefully so you know how to benefit from these additional services.