Spera R edited Ali


Undergraduate Journal of Service Learning and Community-Based Research, Volume 2, Fall 2013      
 

Service Learning:  
Bringing Awareness to Interventions Needed within the Aging Community 

 
Miranda Spera 

Virginia Commonwealth University 
 

Using service-learning activities in a dental hygiene program allows students to 
experience oral health promotion within a local, community setting. The students provide non-
surgical periodontal treatment to a variety of populations, including elderly individuals with 
limited access to these services. The School of Dentistry’s dental hygienist program at Virginia 
Commonwealth University utilizes service-learning activities to allow students to expand their 
clinical experience. Working off-campus under direct supervision of a dentist, students complete 
needed oral healthcare services. During my senior year in the dental hygiene program, I had an 
opportunity to participate in a service-learning activity that profoundly highlighted poor oral 
health conditions within the elderly population. 

Assisted-living facilities offer a variety of therapeutic options addressing residents’ 
medical needs. Medical professionals work directly with residents to improve their quality of 
life. Services offered to residents include exercise programs, arts, crafts, and health monitoring. 
These services encourage creativity, socialization, and continued learning. In a collaborative 
effort to meet dental needs, students from Virginia Commonwealth University extended dental 
hygiene services to help residents maintain and improve their periodontal health.  

During one of my visits to the assisted-living facility, I was deeply saddened by the lack 
of daily attention given to residents’ oral health, mainly removal of food through brushing.  
Medical conditions such as dementia challenge the caregivers and the residents. Many of these 
residents are unable to recognize the need for dental attention. If caregivers attempt to offer 
routine dental care, the residents can become agitated, causing safety risks to the caregiver and 
the resident.  When oral care is not provided, residual food debris accumulates.  

Heavy plaque and calculus accumulations make it difficult to assess the health of 
residents’ periodontal pockets. A caregiver would have to brush residents’ teeth prior to 
performing periodontal assessments, including probing depths. In an effort to share my 
experience with fellow students, I suggested through a blog that they brush the residents’ teeth 
prior to recording those assessments. The levels of plaque and food debris are a hindrance to 
providing oral hygiene during the appointed treatment time. Sadly, many residents refused much-
needed dental x-rays and treatment.  While working in this facility, I began to ask myself: Who 
could make a difference in these residents’ lives?  Are community members aware of the 
problems associated with dental care in assisted living facilities? If they were aware of these 
challenges, would members of the community collaborate with individuals in oral healthcare to 
make the necessary changes?  What types of changes are necessary to make a difference? 

Multi-level modifications are necessary to improve the oral healthcare of the aging 
population in these facilities. The primary level must explore behavior modifications and 
interventions with the residents’ direct caregivers or certified nursing assistants (CNAs). A 
helpful intervention would be to offer a continuing education course on oral hygiene practices, 
specifically in residents with dementia or organic brain syndrome. At the academic level, prior to 
certification, students could complete a presentation on obstacles to providing oral health for all 
types of patients and how to overcome those obstacles. The lesson should include topics such as 
oral cancer screenings, brushing techniques, and overall oral healthcare challenges within the 



Spera 2  

Undergraduate Journal of Service Learning and Community-Based Research, Volume 2, Fall 2013      
 

specific patient population. On a larger scale, community and statewide awareness is necessary 
to improve dental conditions in assisted living facilities.  

Education and awareness empower change. Service learning provided me with a wealth 
of education and the awareness I need to make a difference. There is an urgent need for dental 
intervention within our communities, and discussing and demonstrating proper dental care is one 
way I can offer to help at the ground level. Through service learning, I have found compassion 
for the geriatric patient with altered mental acuity and have been humbled by the opportunity.  
 
~ 
 
I would like to express my gratitude to the following professors for sharing their enthusiasm in 
the field of dental hygiene: Mrs. Tammy Swecker, Dr. Joan Pellegrini, Mrs. Anjum Shah, Mrs. 
Christy Casella, and Mrs. Michelle McGregor.  I am particularly grateful to Mrs. Kim 
Isringhausen, Mrs. Coral Diaz, and Dr. Patricia Bonwell for opening my eyes to the many unmet 
dental needs found within our communities. A special thank you to Dr. Tracy Fasolino for 
reading my manuscript and providing insightful suggestions.