Oral Cancer Screening For Seniors: An Interview with Sonya Dunbar
Today I’m speaking with the Geriatric Toothfairy, Ms. Sonya Dunbar. Sonya, how are you doing today?
Sonya
I'm simply amazing.
Heather-Dawn
With a name like that, no wonder! Can you tell us a little bit more about the Geriatric Toothfairy?
Sonya
Yes, thank you for asking. And thank you for having me on your show. Well, I've been the self-proclaimed Geriatric Toothfairy for about 15 years now.
It started when my grandmother was placed in a nursing home, although I always told her that I wouldn't put her in one.
But when her health got too much for me to handle at home with small children, against my will, I had to put her in one.
I noticed that they weren't taking care of her teeth in the nursing home. So being a dental professional, I felt it was my duty.
So that's what started me on my journey of taking care of who I consider our greatest generation, our seniors.
I need to take care of their mouths.
I was taking care of my grandmother's teeth because she probably wouldn't let anyone else do her teeth.
But also I noticed the people in the other rooms weren’t getting their teeth taken care of, even the lady in the bed next to my grandmother.
She leaned in and said “Baby, can you do my teeth? They don't come out like your grandmother's.”
I started doing her teeth everyday when I did my grandmother's.
As soon as I saw her teeth, she smiled.
So I captured her smile from that point on everyday because in those facilities, everybody kind of talks like it is high school gossip.
So my grandma was bragging that my granddaughter comes and does people teeth. And if you give me two cigarettes, my granddaughter would do your teeth because I wouldn't buy her cigarettes. I told her, “Grandma, you lost a leg and you have a congestive heart failure.”
I went to see my grandma one day, and there was a line outside her door. There were walkers and wheelchairs, and people would come and were waiting for me, as I went looking for my grandmother.
I found her in the courtyard smoking cigarette. She said, “I told everyone if they gave me two cigarettes, you would do their teeth.”
She was the first entrepreneur in the family, but she expired and transitioned to her next journey.
I knew then that she would want me to continue to take care of the people’s teeth, and I started out doing free. But then, I learned how to make it a business.
I'm a big believer that your passion can take purpose and lead you to your destiny in life after.
That's my journey as a Geriatric Toothfairy.
Heather-Dawn
What a wonderful journey! It only takes a spark to get a fire going.
That spark was your grandmother. Loving and caring for her took you into your passion, which allowed you to also get some profits.
So that's a win win, right? So you say you've been doing this geriatric Toothfairy-ing for after about 15 years. How did you get into dentistry?
Sonya
Even as a child, I've always liked to see people smiling when I didn't have any teeth in front of my mouth.
I would stare at people and smile at them, but I noticed some people didn't smile back.
Smiles are contagious.
A smile is like a yawn.
You will yawn if you see someone yawn.
However, at a young age, I noticed people who didn’t smile and who were not happy with their teeth.
I always wanted to capture smiles like I told you. I captured that lady’s smile in my grandma's room. So I always felt that a smile was something that you can give away but still keep for yourself.
It’s absolutely free! Smile does your face good like milk.
Heather-Dawn
Absolutely!
Sonya
That's what started me to wanting to go into dentistry and that's what started my journey.
My long term goal was to become a dentist, but I ended up going into the military.
But I had children so my journey drifted down to being a dental hygienist, which I don't regret because being a dental hygienist afforded me the time to raise my children.
I could work part time and not have so much of the responsibility of owning a practice. Being an associate, it makes money, while being present with my children.
Today, I still have the opportunity to own a mobile dental practice that’s in three states.
Heather-Dawn
Wonderful! I have a million dollar question for you. Who is a geriatric patient?
Sonya
The geriatric patient is an older person that has a lot of sicknesses and someone mostly in a nursing home or is probably at home.
So that’s what made me. I was trying to think of a name that made me the Geriatric Toothfairy. It allowed me to go into the nursing homes and cleaning people’s teeth and doing comprehensive dentistry. We do dentures, extractions, fillings, partials, and everything.
I was only able to save the people that I can touch, but I wanted something bigger than that. So I developed the Geriatric Toothfairy, who is a motivator, an educator and a communicator.
I go around the world. I've been out of the country educating people about proper oral care for the geriatric patient, the dry mouth, the dementia patient, and the patient with a small amount of root in the teeth and gum disease. The geriatric population needs oral cancer screening.
So I've been able to travel around educating the importance of oral care, motivating dental assistants, dental hygienist, and dentist to provide care for the geriatric patient, and communicating the importance of it.
The Geriatric Toothfairy is an oral care educator.
Heather-Dawn
Okay. Are there tooth fairies that make up the team?
Sonya
Absolutely! As for my team, they don't consider themselves tooth fairies, but I do train other dental assistants and hygienists to be Geriatric Tooth Fairies who will be educators and speakers and who will go in long term care facilities and doing simple stuff, such as brushing and flossing of the residents’ teeth.
Heather-Dawn
Okay, I only asked you that because you spoke about restorative dentistry, and I know that hygienists don't do restorative dentistry. So I wondered, have you had some dentists who were fairies as well?
Sonya
I don't know, but I have. I have other people that are Geriatric Toothfairies around the country. And dentists, I work with a team of dentists.
We have a collaborative agreement, work together in the long term care facilities, and do some amazing things together. It takes special dentists to work in long term care facilities.
Heather-Dawn
I can imagine. So, tell me, how does the aging process affect teeth?
Sonya
Aging affects teeth in the same way that it affects the whole body.
Your mouth gets drier because of some of the medications you're on. And when you don't have a lot of saliva in your mouth, you can have cavities.
People think that cavities are just for kids, but it's not. A lot of older people have cavities.
As they age, they also have dexterity problems. They're not able to brush their teeth nor will they remember to brush their teeth. So that opens up the door to gum disease, and they will have to get extractions.
When they have root caries, their teeth break off at the gum line. Then, you have root tips in your mouth. And yes, we do a lot of silver diamond fluoride on the root tip.
That's something that dental assistants and hygienist can do. We do a lot of that, but who wants to take root several root tips out of a 90-year old person with heart problems.
So, most of the nursing home care is palliative care as well as preventative care. The dentist comes in and does a lot of denture.
You don't do root canals and bridges much because it's just not the place to do it, and you're mostly serving them in a wheelchair and a Jerry chair in their bed.
Heather-Dawn
Okay, so how is geriatric dental care different from dental care provided to other patients?
Sonya
The way that it is different from dental care provided for other patients is it's service in a bed or in a wheelchair or a Jerry chair. Most of the people receiving care are in long term care facilities.
Most dental offices chairs are bolted to the ground. It’s very difficult to get a wheelchair or Jerry chair in the dental office.
This is not just an older adult. A geriatric patient has collaborative comorbidities, so oral care is done in a long term care facility or in a controlled setting outside of the dental office.
So the answer to your question is that most geriatric dental care is done in a nursing home, in their bed, in a wheelchair, or something like that.
Heather-Dawn
Okay, awesome! Are there any recommendations that you have for oral care for seniors?
Sonya
Yes, I would recommend using anything with Xylitol where there's some sort of spray in it. It can help reduce caries and moisturize the mouth.
I also recommend electric toothbrushes because the dexterity is making it difficult for them to get all the areas. I also recommend that a geriatric patient get oral cancer screening. It’s so sad how many cases of oral cancer that we discovered in long-term care facilities.
Anybody over the age of 45 is at risk for or has a higher risk for oral cancer whether they have teeth are not.
Many of the oral cancer lesions are found on the tongue. So you can have a tongue without teeth.
Heather-Dawn
So glad you underscored that. Because a lot of people figure, I don't have teeth and the denture is working fine. I really don't need to go to the dentist. So I'm glad you're underscoring that because it's such an important point that is so overlooked.
People think that dental care is for people with teeth.
If they don't have teeth and their dentures are fitting or they're functioning without the dentures, they’re fine.
If they're not feeling any pain, they feel it's all good.
I wanted to just highlight that point. So, are there three things that a dental assistant should be aware of when caring for senior citizen patients?
Sonya
Absolutely!
First, be patient.
Look on your schedule. If you know you have a senior citizen, don't put them in the middle of the day when you're really booked. Make them your last patient before lunch or the last patient of the day. Don't put them when you have a 45-minute block because they may walk slower, they may talk slower, and they may need you to explain stuff to them slower.
That's the number one - carve out that time for that patient.
Second, get on their level.
Never hover over a senior because that can be intimidating. Standing over someone older than you can be intimidating and threatening because you never know. If you're talking to them, sit in a chair next to them and look them in the eye.
Third, always look them in the eye.
Many seniors are trustworthy as far as taking your word for it.
Don’t be looking off and not be paying attention to them. You should be present with them. So when you talk to them, look them in the eye and don't call them by their first name unless they tell you to. So say Mr. or Mrs.
Those are the three pieces of advice I could give.
Heather-Dawn
They are good advice. Slow down and be patient because they are moving at a different pace than you're accustomed to.
- Adjust and adapt to the various types of patients that we see.
- Slow it down, and then don't look down on anybody.
- Get yourself on the same eye level as them, so they don't feel as if you're speaking down to them, or at them, but with them.
They’re all good advice. I think our society is wound up and getting everything done like yesterday, but patience is often missing.
Let me share a story.
One day, my daughter saw me attending to my aunt who’s 95. At the time, she said, “Mom, I don't know how you do it.”
I said, “Girl, one day, I'm going to be there, hopefully. And I would want somebody to be just as patient with me.”
It resonated with her because I saw her outlook change towards caring for my aunt as well. They are the seniors who’ve gained double figures in the 80s and 90s and have given a lifetime of contribution in one way or the other.
The least we could do is slow down and give them some love.
So I always like to give a quote as I come to the end of my podcast, and I'm going to share this one with you.
Kindness is giving hope to those who think they're all alone in this world.
It's amazing how many people who've contributed in one way or another end up in a lonely space.
Thankfully, your grandmother had you. But there are many people in facilities that don't get visitors. Their family members feel that they've done their part by making sure that they are in a facility where they're cared for. And that's it.
So it's so wonderful to know that there's a team of dental professionals who make it a point of duty to go in, show love, and do something where somebody feels cared for. Then, they repay you with a brilliant smile even if it's punctuated with some spaces in between.
It warms a heart to see that you can do something to someone who can say thank you not just financially but with the expression on their face.
So Miss geriatric Toothfairy, this was such a wonderful experience. I hope that our discussion today inspires others who may have a heart for senior citizens to think about doing something similar. You said that you have trained quite a few geriatric tooth fairies throughout. If people wanted to contact you, how could they reach you?
Sonya
It’s at sonyadunbar.com
Heather-Dawn
I want to thank you from the bottom of my heart for taking the time to come and share these wonderful pearls with us. I have one request and that at some point in the future you will return to share some more love.
Sonya
I would love to!
Heather-Dawn
That was time well spent with our Geriatric Toothfairy Miss Sonya Dunbar.
She reminded us that your passion can take purpose and lead you to your destiny in life.
- We have to remember that when it comes to our seniors, you have to be really patient, slow it down, and adjust your appointment times so that they would have enough time to move at their pace, to answer any questions, to ask any further questions, and to not feel rushed.
- Xylitol is great for people who have dry mouth and electric toothbrushes because seniors may not have great manual dexterity.
- We also have to remember that whether there are teeth in the oral cavity or not, we're all susceptible to oral disease and inflammation.
- Cancer screenings are vital. It must be a part of the oral care for our geriatric patients.
- And finally, let's be respectful. Our seniors have poured into us for many years. We need to show them respect.
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Would you like to LISTEN to this article?
This is Episode 20 of my Irreplaceable Dental Assistant podcast.
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