Mouth care is overlooked & undervalued. There I said it!

Many people face multi-complex barriers obtaining preventive dental care services.


Addressing poor oral health among older adults is imperative as this leads to other health problems. The problem of poor oral health among older adults is multi-factorial. Many older adults have difficulty brushing their own teeth due to poor manual dexterity, limited mobility,vision problems, or cognitive impairment. Although I may refer to the elderly in long term care homes, these factors also affect seniors living at home independently and anyone who has not been able to seek care with a Dental Hygienist for more than two years. 

The mouth is linked to the body and the body is linked to the mouth. ⬅ Now read that again!

Some days I feel like a detective. WHAT??? Yes, bacteria in the mouth can contribute to unstable diabetes, increase the risk of stroke, cardiovascular disease, dementia, respiratory infections and even pregnancy complications. It’s greatly concerning to me to know how many people in our community go without preventive dental hygiene care. This was one of the many driving factors of WHY I opened my independent Dental Hygiene practice in 2008. Too many people were going without basic preventive care related to cost and travel factors.

There is a strong correlation between poor oral health and life threatening systemic diseases and conditions. Thick bacterial debris that accumulates on teeth and dentures highly increases the risk of aspiration pneumonia, the number one cause of death in long term care- nursing homes. 

When soft bacterial biofilm is left on the teeth, it will harden into tartar. This plaque and tartar will allow gum disease to progress quickly resulting in rapid decay, the inability to chew properly, swollen and bleeding gums and eventually the loss of teeth. There is a high incidence of this in nursing homes related to the soft texture of food served, high sugar and carbohydrate diets that the elderly are placed on. Now add a dry mouth to the mix, this ends in dental disaster! Dental problems often go unnoticed until someone loses a tooth or when pain is suspected. When someone loses their ability to verbally communicate, dental problems can be disguised as having “behavioural issues”. 

Personally I’ve witnessed shocking cases of poor oral health. The mouth is often overlooked and under investigated when performing “head to toe” assessments. WHY IS THE MOUTH NOT A PRIORITY??? IT IS THE WINDOW TO OUR OVERALL HEALTH!  

One of the main issues stems from not having a Dental Hygienist employed on staff at a nursing home. 

I’ve had to scale out a partial upper denture that remained in someone’s mouth for over six months. No one was aware this person had a denture and was NEVER removed! Another case: A full bottom denture was not being cleaned by brushing and formed such a large chunk of tartar that ultimately rubbed on the bottom inside of the mouth until it formed a large ulceration the size of a “toonie”. YES, denture wearers need dental hygienists too!

Gums will change from poor fitting dentures, this can cause sores and increase the risk of oral cancer. The most heartbreaking situation that still shakes me to my core was the extensive tongue cancer that I detected. This tongue was overlooked for almost a year. The most startling factor is that the tongue had been looked at by a Registered nursing person, nothing was reported or done. I personally drove this person to visit their M.D. This person ended up passing from tongue cancer soon afterwards and this still brings me to tears, even as I write this today. 

Registered Dental Hygienists’ are preventive oral health experts. It is unrealistic to expect another professional to work out of their scope of practice. R.D.H.’s  are primary health care providers. We promote health and focus on oral disease prevention. Our goal is to help maintain proper oral health and provide a wide range of preventive dental services. Some of us even work as Mobile Dental Hygienists, like me!

Personal Support Worker’s (PSW’S) are providing the daily tasks to assist a person with their daily living tasks such as oral hygiene. PSW’s typically have on average six minutes to help a resident get ready for the day, which includes two minutes of tooth brushing. (In nursing homes)

I support our PSW workers and many feel unprepared and scared to take on the responsibility of providing mouth care to individuals, especially when there is a lack of co-operation or when there is a bite reflex involved. There is a fear of being bitten and sometimes feeling the lack of confidence when brushing someone else’s teeth.  I’ve formulated a poster, a quick over view of a person’s mouth to help those caregivers who are providing assistance with daily oral care. PSWs’ simply need support and encouragement. When I first implemented this poster, I didn’t know how something so simple could create a positive & powerful impact within their work environment. Everyone has a story, remember to be kind always. ❤

This is my reality and I am here in my community to promote access to care, to help our older adults overcome the challenges they face. I’ve poured out my heart and soul into this business. The seniors that I spend time with are my life. Honestly, I’ve sacrificed so much personally to be here today and without advertising to keep costs low for all who I serve. Most dental visits with me are $113.00 and I never charge for the extensive dental hygiene exam I perform. Dentists are partners in your oral health and I understand the cost can be expensive. If someone needs to seek care with a Dentist, I feel it is unfair to have someone pay for a second exam outside my clinic. Seniors have my heart and I am fortunate to have the ability to provide this mobile service to them in our community. I greatly appreciate the support and continued referrals.

I work part-time with my business, simply keeping my balance and ensuring everyone who calls upon for help isn’t turned away. It is my burning desire to make dental hygiene care more accessible in for people in Muskoka to improve the lives of others. This is really more a community service. I provided 41 people with free dental hygiene services last year. Kindness matters! Yea, I’m a terrible business lady and I like that.

Can’t travel out? I meet you where you’re at. Mobile care isn’t glamorous, it’s extremely convenient & comfortable. People love to have their teeth cleaned in their own home. Bonus, it is less expensive and highly personalized. Stay in your P.J.’s if you wish. I’m here to make life easier!

No, I don’t have a upscale store front clinic. I welcome you into MY home. Relax and enjoy the Netflix, listen to your favourite music & hang out with our dental dog Bella. Kids really love her gentle disposition. You can expect the same equipment and high quality preventive care services with us.

Dental Hygiene is my passion! Clients always feel highly respected, well cared for and never rushed. Looking for something different? Need a travelling dental profession? Want a relaxed environment, cause your nervous? I’m here and celebrating my 12th year in business next month and I’ve been in the dental field for 19 years now.

Thanks Muskoka, I love our wonderful community!

Sarah Robertson-Smith R.D.H. ❤