As more medical ailments surface in old age, dental care often gets pushed down the list of priorities.
Many elderly people do not have good oral hygiene habits to begin with. Years of neglect lead to dental caries, gum disease and loose teeth.
Some have never even visited a dentist, said Dr Goh Siew Hor, assistant director at Unity Denticare. Those wearing dentures may leave them by the bedside, uncleaned.
Mr Nicholas Chung, nurse manager at NTUC Health Nursing Home (Jurong West), said that when this happens at the nursing home, its staff will brush and clean the dentures for the elderly person.
"I have a resident who has just one tooth left. He would say, 'drop, then drop lor'," said Mr Chung. "But we still encourage him to clean that tooth... Don't give up."
After all, oral health is essential to general health. A person with bad teeth may not be able to eat certain foods and this could affect his nutrition, said Dr Goh.
Oral care and hygiene are a key component of the Health Ministry's Enhanced Nursing Home Standards.
And at NTUC Health's three nursing homes - in Chai Chee, Jurong West and Geylang East - residents are encouraged to brush their teeth three times a day - in the morning, afternoon and before bedtime.
Staff help to do oral swabs for tube-fed residents and the bedridden. The national standards stipulate that oral hygiene be carried out at least once a day, including for those who are tube-fed.
NTUC Health also works with Unity Denticare to have a mobile dental clinic parked at each of its nursing homes every six months.
This is a boon for residents with dementia, as they prefer to be in familiar surroundings. It can be difficult to take them to a dental clinic, said Mr Chung. "Some would refuse to go out, even if we call for an ambulance or a van. They think that something bad is going to happen."
With the mobile clinic, however, staff can "wheel them there and they can see that it's still part of the home", he added.
A few weeks before the mobile clinic is scheduled to arrive, staff identify suitable residents and ask them or their caregivers if they are interested in the dental service.
The bill can be paid with subsidies under the Community Health Assist Scheme or pioneer generation benefits. For those who are not eligible, staff would ask the family if they are willing to pay.
The mobile clinic charges are 5 per cent to 10 per cent cheaper than at regular dental clinics. The cost of extraction ranges from $65 to $190, while scaling and polishing costs $50 to $105.
Though it is ideal for most of the elderly to get regular dental check-ups, consent is still needed.
"Many may not have visited a dentist, so they could be fearful," said Dr Goh. "We don't force them."
But in a critical situation - for example, if a resident risks accidentally swallowing a loose tooth - he will be taken to a dentist.
Having a mobile dental service also causes less disruption. "Without the mobile dental clinic, it will be very hectic. We will have to make individual appointments and take (residents) out one by one. Sometimes, on the day itself, the elderly person will say he does not want to go," said Mr Chung.
Madam Fong Miew Leng, a resident of the Chai Chee home, may be 84 but still has a healthy set of pearlie whites. "I can eat everything except prawns, but that's because I get a rash," she said in Mandarin.
The silver-haired mother of three was snacking heartily on Milo and biscuits in her wheelchair while waiting for her turn at the mobile clinic. "It's nice to have the whole machinery here," she said.
Poon Chian Hui