Oral Health Education at Senior Nutrition Sites

O3A designed and produced laminated placemats with oral health puzzles and games that emphasize the importance of oral health for use at congregate senior nutrition sites.  The placemats are washable and reusable.  The placements were distributed with dry erase pens at congregate nutrition sites in four counties and then participants were surveyed to assess their reactions.  In addition, O3A nursing staff provided one-on-one consultations with individual participants about the importance of oral health at one of the larger sites.  Participants also received written oral health information and “Smile Bags” that included toothpaste, toothbrush, and floss.

Submitted by: Barbie Rasmussen, Director, Planning & Program Management, Olympic Area Agency on Aging

Project Goal(s) and Objective(s)
The goals for this activity were:

  1. To provide oral health information  and its links with  overall health and well-being to older adults at congregate senior nutrition sites
  2. To provide older adults with information on how to prevent or mitigate oral disease, as well as maintain good oral health, particularly if affordable dental care is difficult to access

O3A information technology and nursing staff collaborated to develop messages, word puzzles, games, and graphics in order to produce seven different versions of a laminated reusable placemat for use at senior congregate meal sites.  The placemats were printed in color on 11”x 17” paper.  The front of each placemat features “10 steps for a healthy mouth,” used with permission from the Washington Dental Service Foundation; this side was the same for all placemats.  There are seven different versions of the back of the placemat, each with a different word puzzle (crossword, word find, or maze), along with bullet points listing different oral health facts.

We printed, laminated, and distributed 800 placemats, along with a supply of dry erase pens, to senior congregate sites throughout Clallam, Jefferson, Grays Harbor, and Pacific counties, as well as several community centers.  We asked the senior nutrition program staff to use the placemats during meal service for several weeks and then survey program participants to learn their reaction to the placemats.  O3A staff developed a simple, one-page survey that was copied and distributed to the senior nutrition sites for program staff to hand out.  The survey asked whether participants liked the placemats; if they gained new information; if they planned to make positive changes regarding their own oral health; and whether they planned to share information with others. We also asked them to identify challenges they or their friends, neighbors, or family members face accessing oral care.  Surveys were then collected and the responses compiled in a simple excel spreadsheet.

  • One-on-one conversations with the O3A nurse at the senior center
    In one Senior Center, the O3A nurse set up an information table during lunch hour and held one-on-one conversations with 25 senior center participants about the importance of oral health; she also distributed the Oral Health for Older Adults brochure along with the “Smile Bags.”
  • “Smile Bags” with dental supplies and oral health information distributed
    Brochures and “Smile Bags” (toothbrushes, toothpaste, and dental floss) were distributed to participants at congregate senior nutrition sites.

Senior Nutrition Participant Survey Summary

32% responded that the cost of dental care was an issue for themselves or their peers.
Comments: “The challenge is not being able to afford dental insurance” “The cost is too much for many” “Can’t afford” “Too costly”

22% responded positively to the placemats.
Comments: “Placemats were fun for the first few days, after we got done with the games and reading info” “Fun facts”

22% responded that they either learned something new, or indicated something they could change.
Comments: “Did not know about seeing a dentist yearly because I have dentures” “Floss more often” “Find a good dentist”

14% responded with a negative comment, or that the games were childish.
Comments: “Why couldn’t the money for this be used for dental care for low income?” “Shouldn’t this be given to kids?” “Why wait until we have no teeth?”

11% responded with non-specific comments.
Comments: “Not interested” “No placemats”

Lessons Learned

  • It is not necessary to laminate the placemats for use in senior congregate sites that regularly use paper placemats.  Placemats can be reproduced on paper, used once and discarded, and participants can use their own pens/pencils to complete the games.  This saves both senior nutrition program staff time, as well as the costs to laminate the placemats and provide the dry erase pens.
  • Increase the level of difficulty of the word games and puzzles.


One of the requirements of senior nutrition programs is to provide nutrition education to participants.  Many programs find that written information—on placemats, flyers, recipes, etc. — is a cost-effective way to provide such learning.  For those congregate sites that use paper placemats, the senior nutrition program or AAA can reproduce the oral health paper placemats at relatively little cost.  Along with providing important information on oral health, the placemats also provide some variety in the educational materials provided through the senior nutrition program.