Dental Health is Critical to Post-Acute Rehabilitation at NeuLife Rehab

When an individual sustains a catastrophic injury such as a traumatic brain injury (TBI), a mild brain injury (MBI), trauma of some type, multiple trauma, neurological injury such as a stroke, a spinal cord injury (SCI) or a traumatic amputation, the first critical step is to obtain acute care.

It’s probably fair to say that when the catastrophic injury first occurs, no one is thinking much about dental health as the term is usually used. Certainly, if the trauma is to the head, such as from a fall or from a motor vehicle accident (MVA), there may be tooth or jaw fractures that needs acute attention, short-term care and specialized rehabilitation to return the mouth to normal use.

The term “dental health” (sometimes called “oral health”) refers more precisely to the day to day care of the mouth and teeth that is important to overall health. It touches every aspect of life but is often taken for granted. The mouth, in a major way, reflects the overall health of an individual’s body. For example, it can show signs of nutritional deficiencies or general infection. Systemic diseases that affect the entire body may first appear as anomalies in the mouth, such as lesions or other oral problems.

The elements of innovative rehabilitation at NeuLife Rehab in Mount Dora, Florida, our Clients advance to independence to the fullest extent that their physical and mental abilities allow. The specialty of “Occupational Therapy” is part of the milieu of innovative rehabilitation at NeuLife Rehab assists Clients to regain the ability to maintain dental health.

Dental care and oral hygiene programs for persons with traumatic brain injury (TBI) have been relatively ignored areas of clinical care and research. A study reported by the National Institutes of Health recognized that dental and oral care hygiene programs for individuals with traumatic brain injuries (TBI) were sparse. The study, therefore, focused on the efficacy of improved dental hygiene for that population. The study involved a group of 20 individuals (half had TBIs, and half were a control group). Those who had traumatic brain injuries (TBIs) were, at least, one-month post-injury and had a Rancho Los Amigos Scale score of 6 or greater. Oral hygiene status was assessed by a dental hygienist who measured plaque. The individuals who had traumatic brain injuries (TBIs) were given instruction as to how to attend to oral care, red disclosing tablets and other implements while the control group did not get any. At the end of the study, it was found that the individuals with traumatic brain injuries (TBIs) and who had been instructed as to proper oral care had better-sustained results than the control group. The study concluded that early oral care interventions with individuals who had traumatic brain injuries (TBIs) can effectively promote effective plaque control.

Prevention of oral disease is of paramount importance for individuals with physical and mental disabilities. Programs must be developed early and carried out on a long-term basis. Ideally, oral hygiene procedures should be incorporated into daily rehabilitation, education and occupational therapy programs. The individual who sustained the catastrophic injury should be involved in performing their own oral hygiene as much as possible.

Recommendations include:

• brushing teeth after each meal and before bedtime
• tooth brushes can be modified to enable individuals with physical disabilities to brush their own teeth
• automatic toothbrushes may improve compliance
• use fluoride toothpaste or fluoride gel
• flossing should be accomplished daily, however, it may be difficult for some individuals to perform. Assistance may be needed to perform flossing.
• use of a disclosing solution may be beneficial in promoting behavioral changes in cooperative individuals to visualize areas not adequately cleaned
• sealants may be beneficial in adults when oral hygiene is not ideal
• chlorhexidine mouth rinse may be beneficial in managing gingivitis and periodontal disease. This product should be swished and expectorated; individuals who might swallow a rinse could benefit from its application with a toothbrush or cotton swab.
• topical fluorides are indicated when caries rates are high or the individual experiences xerostomia (dryness of the mouth); use brush-on gels, mouth rinses, as well as professional application during prophylaxis
• xerostomia is a frequent problem for many people with disabilities; artificial saliva, sugarless hard candy, or sugarless gum may help to keep the oral cavity moist and decrease the risk of oral disease
• dietary counseling may need to be considered for long-term prevention of dental disease
• dental recall should be planned in accordance with the patient’s needs and abilities. People with severe dental disease may need to be seen every two to three months, or more often if necessary.

When an individual becomes a Client of NeuLife Rehab in Mount Dora, Florida, he or she undergoes an independent functional evaluation administered by a multidisciplinary team of professionals that may consist of:

• Board Certified Neurologist
• Board Certified Behavior Analyst
• Board Certified Physiatrist
• Neuropsychologist
• Psychologist
• Board Certified Psychiatrist
• Speech Language Pathologist/Cognitive Therapist
• Physical Therapist
• Occupational Therapist
• Nurses
• Licensed Mental Health Counselor

From the results of the independent functional evaluation, the professionals of NeuLife Rehab formulate a Client Goal Plan. The Client Goal Plan guides the clinically relevant services delivered by NeuLife Rehab. The Client Goal Plan guides the cognitive, psychiatric, neurologic, psychological and neuropsychological therapy of the Client. The goal of NeuLife Rehab’s innovative post-acute rehabilitation is the attainment for our Clients of independence to the fullest extent that his or her physical and mental abilities permit.

NeuLife Rehab in Mount Dora, Florida consistently provides the highest standard of care in the delivery of clinically relevant services to achieve successful, sustained outcomes and exceed the expectations of all persons served.

Proper and timely post-acute rehabilitation that may determine the difference between disability and independence is what NeuLife refers to as the “platinum post-acute period” —  the crucial window following acute care that is needed to nurture the whole person to health with specialized, clinically relevant services.

NeuLife Rehab’s philosophy is that healing, wellness and personal fulfillment are best accomplished in a positive and uplifting therapeutic environment where caring staff encourage, assist and support each Client so that he or she may achieve specific goals. NeuLife Rehab believes personal philosophy is equally as important as goals to increase function and independence.

NeuLife, in Mount Dora, Florida, is an accessible residential post-acute program providing specialized rehabilitation to individuals diagnosed with Traumatic Brain Injury
(TBI), Spinal Cord Injury (SCI), Amputations, Burns and other Catastrophic Injuries and Challenging Diagnoses.

2725 Robie Avenue

Mount Dora, Florida 32757