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Bronx VAMC Innovations in Holistic Oral Hygiene for Spinal Cord Injured Vets

By Robert B.

Itís been said that a lack of attention to oral care can adversely affect nutritional intake and have a serious negative impact on the patients' overall physical health and well-being. This is particularly true of the Spinal Cord Injury (SCI) inpatient whose serious medical conditions make them especially vulnerable. The Bronx VA Medical Center has developed and implemented holistic oral hygiene protocols to improve the dental care for their patients. "Our SCI veterans face many special challenges on a day-to-day basis," said Doctor Daniel MacDonald, Director of the SCI Dental Service, "getting them to our dental clinic from the SCI ward presented difficulties for patients and practitioners. Treating them at their bedsides, presented other difficulties too. We felt it was necessary that we improve this process."

In the past, staff experienced great difficulty in transporting patients from the SCI unit dental services located on different floors. Patients on respirators and complex therapies required great care and resources that were not always available. Ventilation of these patients required nursing personnel, a respiratory therapist, and physical therapist to negotiate safe transport to the dental service and monitoring during the procedure. Also, bringing the care to bedside presented additional challenges. Beds in SCI are wide, making it awkward for the dentist to properly provide treatment. Larger dental equipment requiring compressed air, specialized water lines, evacuation, and electrical requirements could not be negotiated in the patient's room.

"Proper dental care fosters appropriate nutrition, maintenance of immune status, and good general health." Said Lynda Olender, Chief Nurse Executive. "Moreover, the cosmetic aspect of dentistry will help increase patients' self-esteem and acceptance in public. We believe it's important to treat the patient by a holistic oral hygiene approach, considering all contributing factors; not just the obvious physical injury alone."

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