Ashlee Handeland

Katie Thigpen
DHYG 1315 Community Dentistry
Needs Assessment
A. General Data
1. Description of Site
Absolute Therapy Services also known as ATS was established in June 1999.
They are located 3105 Labrador Lane, Port Neches TX, 77651. Absolute Therapy
provides Physical occupational and speech therapy to patients who are ill or
disabled and are receiving care from a home health agency. Patient care includes a
thorough assessment of the patient, patient care planning, direct patient care,
teaching supervision, in-service training and much more. (1) Absolute Therapy is
privately owned and operated.
2. Description of Target Group
The target group for our Oral Health Program are ill and disabled patients
receiving care from a home health agency in the Greater Golden Triangle and
surrounding areas. The company does 40,000 visits annually (1) They treat
approximately 100 patients a day.
3. Description of Staff Population
The company has a total of 20 full time employees and 6-part time
employees. The responsibilities of the staff are patient evaluation,
discharge, supervise and assist in treatment. The physical therapists have
bachelors or masters degree and the physical therapy assistants have
associates degrees and they are all licensed in physical therapy. (9)
4. Description of Services Provided
The coordinator of activities is run by the owner who has a masters in
Physical Therapy. Activates provided are regional and are targeted for ill
and disabled patients. Future plans for the company, which are currently
being implemented, is having staff work with Baptist hospital on the
weekends. (9) In the daily routine the employee goes to a patients home,
assesses the patient, makes an individualized treatment plan then
implements the treatment to help the patients get back to living
independently as quickly as possible.

5. Other Pertinent Data

Water Fluoridation
Because Absolute Therapy treats the Greater Golden Triangle area there are
variations in the water fluoridation at parts per million. Port Neches, Port
Arthur and Beaumont have a water fluoridation level of 0.7mg/l, Nederland
has no water fluoridation, Groves has .10mg/l of water fluoridation,
Hampshire Fannett is mixed, they use well water and the levels vary
throughout the year. (5)
B. Information Related to Dental Health
The Dental Services are Limited and are only utilized if the patient is unable to
perform their daily oral hygiene. If the patient is unable to perform their oral
hygiene the physical therapist will assist them. If attachments or grips are needed
they will provide them for the patient. The company has limited dental supplies;
they generally use the patients oral aids. They have not had any previous dental
programs. The staffs knowledge and awareness of dental health is also limited.
They are educated to an extent- they know the basics of brushing and flossing. (9)
C. Dental Health Status
1. Dental Caries:
Although dental caries is a common disease in children, the percent of adults
ages 20-64 years with untreated dental caries is 23.7% from 2005-2008. This
number is in fact higher than the percent of children ages 6-19 years with
untreated dental caries, which was 15.6% from 2007-2010. (2) The patient is at an
increased risk for dental caries if they are disabled and unable to properly care for
their oral cavity. They are also at increased risk for caries if they are not receiving
optimum levels of fluoride.
2. Periodontal disease:
Periodontal diseases are mainly the results of infections and inflammation of the
gums and bone that surround and support the teeth. 47.2% of adults age 30 ears
and older have some form of periodontal disease, 70.1% of adults 65 years and
older have periodontal disease. (3) The patient is at an increased risk for
periodontal disease if they are disabled and unable to properly care for their oral
cavity. The ill and disabled patient needs to be very cautious when it comes to
their periodontal health. They need to be very thorough with their oral hygiene
practices to prevent other health complications.
3.

Oral hygiene:
Oral hygiene goes hand in hand with overall health and is very important for
disabled patients. Nearly one-third of all adults in the United States have
untreated tooth decay. One in seven adults aged 35 to 44 years has gum disease.

(4) For the patient to have good overall health they need to start with practicing
good oral hygiene to achieve optimal health. Disabled patients often have
difficulties with daily brushing and flossing, therefore one must make adjustments
according to their patients needs.
4. Malocclusion- This is not relevant to our oral health program.
5. Oral cancer- This is not relevant to our oral health program.
6. Utilization of Dental services:
The patient is receiving health care at their home, they are less likely to follow
through with appropriate dental treatment. The patient may not have adequate
assistance to get to and from a dental office. This could result in patients lacking
proper patient education needed to implement correct dental hygiene skills and
any modifications needed.
GOAL
Our goal is to provide an oral health program for the staff of Absolute
Therapy Services.
Objective:
1.To increase the dental health knowledge of the staff at Absolute Therapy
Services with our pre and posttest by 20%.
2. Increase the utilization of dental services by inviting the patients of
Absolute Therapy Services to come to our Dental Hygiene Clinic.
3. Provide the Absolute Therapy Services a list of dental resources
available to them.
4. Assist the staff in daily plaque control methods.

RATIONALE:
People with disabilities often need extra help to achieve and maintain
good health. Oral health is no exception. The United States Americans with
Disabilities Act (ADA) defines an individual with a disability as a person who has
a physical or mental impairment that substantially limits one or more major life

activities, has a record of such impairment, or is regarded as having such

impairment. (10) Today, approximately 80 percent of those with developmental
disabilities live in community-based group residences or at home with their
families. (8) People with disabilities experience a diminished oral health status
and reduced access to dental services compared to the general population.
Together with their caregivers, they now look to practitioners in the community
for dental services.
Some adaptation of the skills you use every day is also necessary to
ensure safe and effective patient care. When the dental team is informed and
prepared, most people with mild or moderate developmental disabilities can be
treated successfully in the general practice setting. The reason oral health is
suffering is due to a lack of oral health knowledge by the care providers working
with the disabled patients. The physical therapist and aid do not usually include
oral hygiene in the patient care plan, due to a lack of knowledge on the subject.
The staff that works with the disabled are lacking knowledge when it comes to the
patients oral cavity, therefore the staff needs to be educated on how to properly
care for the patients and their oral cavity. In most cases, the staff would not be
able to tell if the patient has an infection in the oral cavity or not. The staff should
be aware of gingivitis and periodontitis and its effects on their overall health. The
need for oral health programs in Physical Therapy offices are not only for the
disabled but for the staff too. The staff should be involved so that they may learn
and can help determine the disabled patients oral health needs.

In conclusion, there are many things to consider when assessing

the need for an oral health program in a Physical Therapy office. The documents
used are evidence that there is a need for an oral health program for Physical
Therapists and their staff. Dental health, restorative care, and prevention can help
contribute to improving the patients overall health who may have lack of access
to care.

Program Design
A. Activities
The program plan is aimed at education the staff at Absolute
Therapy Services involved with the care of disabled patients. The
educational sessions will consist of teaching basic dental health
care topics, oral hygiene practices and the importance of good oral
health. The sessions will be performed weekly at Absolute Therapy
Services. These sessions will be developed in the following way.
Session 1 (week 1)
A. Owner-Physical Therapist
Introduction of general information related to the oral health of the
patients.
1. Discuss the need for preventive dental health program for the
patients.
2. Provide a written pretest on basic oral health care.
3. Discuss the importance of good oral hygiene.
4. Discuss available resources
5. Discuss the use of the LIT dental hygiene clinic for
preventative dental services for the patients.
6. Discuss adding oral hygiene in the patients care
7. Discuss protocol for dental emergencies.
This session will require about 45 minutes and will only
require the program planner.
Session 2 (week 2)
B. The Staff at Absolute Therapy Services
Introduction of general oral health information and preventive
techniques. This session will include an evaluation of the staffs oral
health knowledge.
1. Pretest the staff to assess their basic oral health knowledge.

2. Instruct staff on how to properly care for patients oral cavity.

3. Demonstrate the proper way to brush
4. Advise regular visits to the dentist
Session 3 (week 3)
C. The introduction of gingivitis and periodontitis
1.
2.
3.
4.

Discuss Gingivitis and what causes it.

Describe the first signs of gingivitis.
Discuss Periodontitis and what causes it.
Demonstrate the proper way to floss.

Session 4 (week 4)
D. Review all previous instruction.
1. Review proper brushing and flossing.
2. Review gingivitis and Periodontits.
3. Administer Posttest.

E. Constraints and Alternative Strategies

Constraint: The staff may not be interested in learning due to lack of
dental knowledge, and interest in oral health.
Alternative:
1. Explain the importance of the information we are teaching the
staff.
2. Keep information in clear terms for them to understand.
3. Include visual aids and demonstrations.
4. Ask the staff to relay the information taught.
Constraint: The patient undergoing therapy may have a difficult time
holding a toothbrush and floss.
Alternative:
1. Develop an aid that may help with dexterity issues, such as placing a
tennis ball or bicycle handle at the end of a toothbrush handle.
2. Provide floss holders and demonstrate how to correctly utilize it.

F. Resources:
The following resources will be required for implementation of the
program.
1. Personnel: Program planner; Physical Therapist and Assistants.

2. Videos: for the staff=

3. Supplies:
A. Toothbrushes, toothpaste, floss, super floss
-provided by Johnson & Johnson, Colgate Oral Pharmaceuticals,
Lamar Institute of Technology Dental Hygiene Clinic
B. Gloves, Masks, Cotton Swabs, disclosing solution, Paper napkins,
cups-provided by program planner
4. Visual Aids: A. Flip book- provided by program planner.
B. Typodont and tooth brush- provided by program planner.
G. Budget: Estimated cost for the Oral Health Program:
Toothbrushes- $0.00
Toothpaste- $0.00
Floss-$0.00
Paper napkins and cups- $5.00
Box of gloves- $8.00
Masks- $3.00
Cotton Swabs- $5.00
Disclosing Solution-$5.00
Total Cost=$26.00
H. Timetable: Four Sessions, Four times a week for 45 minutes. The day
of the week will depend on the availability of the staff.
Session One: Week of March 21st
Session Two: Week of March 28th
Session Three: Week of April 4th
Session Four: Week of April 11th
Evaluation:
A. Formative:
1. A brief discussion with staff will be conducted weekly to ensure
satisfaction and continuation of the program plan and make nesscecary
modifications if needed.
2. Success and individual comprehension will be assessed through
questions at the end of each presentation.
B. Summative:

1. Pre Test and Post Test will be given to the staff members to
asses and compare their knowledge of dental health.
2. Assess the number of people who utilized the Dental Hygiene
Clinic
3. A list of dental resources was handed out to all of the staff.
4. Asses daily plaque control by taking plaque scores.
5. The success of the overall program will be evaluated by a
questionnaire given to the director upon the conclusion of the
program.