Creating a Healthcare Initiative: Oral Care Aides to NATION

Everyone has experienced illness or physical impairments that cause them or a loved one to need assistance in the activities of daily living. An often neglected area of self-care is the mouth. With research clearly linking oral disease with several systemic conditions we're establishing a healthcare initiative that will add a NEW member to healthcare teams. This member is the Oral Care Aide or OCA for short. The OCA is trained in oral anatomy, oral screening and gentle plaque removal. Their care requires lights, mirrors and unique tools that are not common in health settings. OCA's will stop oral disease progression and increase early access to dental care when needed.

We're Toothbrushers and Balaam's Donkey—a group of volunteers committed to serving underserved communities with love, compassion, and top-notch oral screenings and personalized toothbrushing assistance. *Our team visits facilities where people with self-care deficits reside to provide our unique care. *Check below for Patti's real-life transformation story!

In addition, *our animals visit schools, care centers, hospitals, parades, churches, and more to spread joy while raising awareness of the need for a new healthcare worker, the OCA (Oral Care Aide). *Check below for a powerful real-life Joyful Donkey story!

We equip our volunteers with open hearts, listening ears, and the skills necessary to make a difference in the lives of those who may struggle with self-care due to cognitive or physical disabilities. Our goal? To ensure that everyone enjoys a healthier smile and improved overall wellness, regardless of their circumstances.

Research shows a significant link between cognitive decline and the deterioration of dental health (Julkunen et al., 2021). We aim to be a link in comprehensive care for those who need it most.

Your support is vital to our mission! Every donation helps us purchase essential equipment and supplies—from toothbrushes and fluoride solution to floss and dental mirrors. Each contribution enables us to serve more individuals in need, bridging the gap between healthcare and dental care providers.

What's more, your generosity will fuel Mike's May 2024 Ride Across Iowa, a special initiative designed to raise awareness about our mission and reach even more communities across the state.

By donating today, you'll join us in creating a healthcare initiative that brings brighter smiles and better oral health to those who need it most. Let's work together in promoting inclusivity, dignity, and a sense of belonging among individuals with disabilities.

With gratitude and smiles,

Anita, Mike, and the Toothbrushers and Balaam's Donkey Team

Jack's Joyful "Donkey-Intuition" Story:

Cowboy Mike, atop his faithful mule John, leads donkey Jack down sidewalks and across busy parking lots and roads to their destination: a long-term care center and rehab facility. When Mike and the animals cross the side yard into the garden area behind the facility, they see the pretty fenced yard packed with people of various abilities. Some have walkers, others are in large powered wheelchairs, and several wheel themselves with their own arms on the wheels of lighter wheelchairs. Older folks are seated in folding chairs with canes and walkers nearby. Staff from various departments are present too, mostly clustered in corners scrolling their phones. When Mike enters, some staff begin taking video of the odd-looking group. Many haven’t ever seen mules or a donkey as big as Jack!

Once Mike and John move into the group of onlookers, Jack’s tow rope is let free. Jack enjoys people petting him and scratching his big ears. Mike gets people laughing with his silly stories, and everyone seems to enjoy the facts Mike shares about mules and donkeys. Lilly the lab and Scarlett the doodle wrestle in the grass, chase balls, and get snacks from the residents.

The day is going much like other donkey-visit days. People continue to take selfies with Jack, Mike entertains others, and some people are playing with the dogs. Then, a voice from one of the staff rings out, “Hey, where is that big donkey going?” She said in alarm, “Catch him, he’s going towards Mary!” As I looked over to Jack, I saw he had turned from his admirers and was in fact weaving through the crowd seemingly aiming at a lone woman in the far corner. I moved in his direction as I said, “No worries! I’ll watch him closely. Let’s see what he’s up to.” Luckily, no staff member was close enough to stop him, and Jack made it to his destination. The woman, I assumed, was Mary, reclined in a large chair that had tiny wheels. She was swaddled in a blanket with two neatly stacked hands on top. The expressionless face and fixed eyes caused Mary to seem more like a statue than a person. Jack’s large body towered over her, just inches from her chair. It took all my resolve not to interfere with whatever Jack had up his donkey-sleeve, but out of respect for the concerned voice, I softly picked up the end of Jack’s lead rope. The rope would allow me to quickly pull Jack away from Mary if needed. But first, I wanted to see what Jack had in mind.

Mary's half-closed eyes seemed unaware of anything, including the huge donkey directly over her. Getting no response from Mary, Jack lowered his enormous head into Mary’s lap and pressed his soft muzzle on top of her folded hands. He remained in this position for several seconds. We all watched and waited. Then it happened! We saw one hand turn over and then the other until they both were lifted above her lap, cradling Jack’s soft muzzle. It was beautiful; her hands were reaching up to his warm breath and gently caressing Jack's silky, soft lips and nose. Then my heart almost burst with joy as I saw Mary's eyes blink open and fill with tears, and her face come alive with a smile.

At that very moment, I heard a man’s voice and glanced over to see a man exiting the building, saying, “Oh, I’m glad you brought the animals over to Mary. She had horses her whole life up until that big stroke brought her here.” My heart still hurts as I imagine having to get rid of our animals like poor Mary did. How did Jack know that Mary needed him? It seems he has a superpower that I can’t quite understand. He’s had other events where he seemed to have a weird inner knowledge of people who needed a donkey touch too. These times have confirmed our mission to spread joy with the animals.

Every time we go on a Donkey-visit we bring four animals. A mule, Jack the donkey and our two dogs. The dogs do a few tricks, and they each have a unique method of getting attention from onlookers. One likes people to toss a ball or play tug, the other wants to cuddle. People seem to quickly figure out which one is their favorite. All of our mules enjoy scratches and treats and of course Jack the donkey runs the show. Maybe someday we will bring our fat cat who also loves to be cuddled? That is yet to be determined. But one thing we know for certain and that is people are touched in a very special way by animals. Please help Jack and his furry buddies share more special bonding with new people by supporting our non-profit.

Patti's Life Transformation Story:

With my tray of fresh supplies in hand, I stepped hopefully toward Patti. Her metal walker plunked in front of each step, seeming a fortress to her tiny frame. Including the tuft of bed-tussled hair sticking up from her head, she barely measured 5 feet tall. As my pre-dental student and I drew closer, the sadly familiar odor of severe periodontal disease filled the air around us. It must have been a rough morning for her and the CNA’s, as I noted she was still in her sleeping clothes. The facility and staff where Patti lived were top-notch, but she could be a handful, and everyone had learned to choose their battles. Patti really needed our assistance, but her level of cognitive decline caused her to be combative, and though tiny, she could bite and wield a mean swing with her walker. Today would be my fifth attempt at gaining access to the teeth and oral cavity behind those firmly clamped lips and the first time a student would be involved. There were no instruction manuals for us to follow. In fact, we were carving a way through a wilderness that no one had journeyed before. Each client needed unique care, and we were attempting to create methods and curriculum that can be implemented nationwide.

It felt as if all past events in my life had led me to this mission. The OCA (Oral Care Aide) Pilot project needed to be a success! It had been two long years of hard work to finally secure a grant, enough donations, two care facilities, and student volunteers to implement this project. We had a lot on the line, so my partner and I were strongly considering dropping Patti from the program due to her aggressiveness and failure to cooperate. I knew in my heart that today was Patti’s final chance. I couldn’t continue to throw away valuable supplies. I also felt responsible to protect the students from the real risk of being hit or bitten, which is why no one had accompanied me in my previous attempts to provide oral cleansing for Patti before today. I prayed today would be different, better.

Kelvin, a predental student at the University of Iowa, said he was up for the challenge. I explained the risks and my failed attempts. He knew each step in our gentle and progressive method of oral cleansing well. I told him that I had managed to gently swab her front teeth with a saturated gauze but nothing more. “Imagine Patti is your grandma,” I told Kelvin as he took the tray we had prepared for Patti from my hands. “Fill your heart with genuine love for her and be patient,” I continued as Kelvin left my side and settled into one of two comfy chairs near Patti. He sat the tray on a tiny table between the chairs and smiled up at Patti.

Kelvin asked Patti to have a seat with him. He wisely chatted with her for a few minutes before attempting to touch her. Then, as he had been trained, he placed a foam cushion on the floor in front of Patti’s chair so he could kneel near her, allowing their faces to be at a similar level and Kelvin’s back to remain in a comfortable position. While he continued speaking kind words, he put on his surgical gloves, wrapped a gauze square around his finger, and dipped the gauze into stannous antimicrobial solution. Softly placing his gloved hand on her cheek near her mouth, he informed her that he was going to apply this solution to her teeth and gums. “This solution strengthens your teeth and kills bad germs in your mouth. It tastes minty too!” I heard Kelvin say as I watched amazement and delight as Kelvin gently progressed through each step of plaque removal. Some of the steps were modified and not as thorough as needed, but the session was an enormous success! I could have done a cartwheel I was so excited. But the best was yet to come.

We continued to progress in our toothbrushing sessions with Patti, and the changes we witnessed were nothing short of miraculous! No longer did we see a messy, unkempt little lady but instead we enjoyed a woman that allowed the hairdresser to cut and style her hair, she allowed the staff to bathe her, and she wore pretty clean clothes. She was smiling and humming instead of scowling and stressed. The odor went away along with the bed-tousled hair and grouchy disposition. The staff and Patti’s husband were amazed at the wonderful transformation and asked if we had put a magic spell on her!

If you'd like to read more about the association between disability and oral health in assisted living centers, please see below!

Chen X, Clark JJ, Chen H, Naorungroj S. 2013. Cognitive impairment, oral self-care function and dental caries severity in community-dwelling older adults. Gerodontology. 32(1):53–61. doi:https://doi.org/10.1111/ger.12061. https://pubmed.ncbi.nlm.nih.gov/23758583/

Julkunen L, Hiltunen K, Kautiainen H, Saarela RKT, Pitkälä KH, Mäntylä P. 2021. Oral disease burden of dentate older adults living in long-term care facilities: FINORAL study. BMC Oral Health. 21(1). doi:https://doi.org/10.1186/s12903-021-01984-4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8650260/#CR9

Lindroos EK, Saarela RKT, Suominen MH, Muurinen S, Soini H, Kautiainen H, Pitkälä KH. 2019. Burden of Oral Symptoms and Its Associations With Nutrition, Well-Being, and Survival Among Nursing Home Residents. Journal of the American Medical Directors Association. 20(5):537–543. doi:https://doi.org/10.1016/j.jamda.2018.10.025. https://www.sciencedirect.com/science/article/abs/pii/S1525861018306054.

Jesus Washed Feet, We Brush Teeth!