Palliative care patients are susceptible to oral problems that can impact their oral functions and quality of life. Regular mouth care is therefore an important aspect of palliative care, aiming to prevent oral problems before they arise, and optimizing comfort.
Common Oral Problems
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Oral thrush
- An infection of the fungus Candida albicans
- Commonly appears as white plaques on the tongue, palate, and inside the cheeks
- Possible causes: poor oral hygiene, dry mouth, antibiotic use, poor immune system
- Your medical team will prescribe antifungal treatment
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Xerostomia
- Subjective sensation of dryness of mouth
- Possible causes: mouth breathing, oxygen use, certain medications e.g. opioids
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Stomatitis
- Inflamed and sore mouth
- May occur anywhere in the mouth including the lips, inside of cheeks, gums, tongue, and palate
- Possible causes: Head and neck radiation therapy, infection, dry mouth
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Halitosis
- Bad breath
- Possible causes: poor oral hygiene, dry mouth, coated tongue
Mouth care in the last hours of life
Lips
- Apply white soft paraffin or over-the-counter lip balm over dry, cracked lips
Oral cavity and tongue
- If able to drink and swallow, provide ice chips or sips of water
- If unable to drink or swallow, use oral swab sticks to apply water or oral care agents (e.g. Oral7 Mouth Gel) liberally over the tongue, palate, inside of cheeks
- Use ¼ tsp sodium bicarbonate in ¼ cup water to clean tongue coating
Dentures (if any)
- Remove dentures, and brush thoroughly with denture brush and warm water
References
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Aldred MJ, Addy M, Bagg J, Finlay I. Oral health in the terminally ill: a cross-sectional pilot survey. Special Care in Dentistry 1991; 11: 59-62.
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Davies AN. Oral Care. In: Cherny IN, Fallon M, Kaasa S, Portenoy KR, Currow CD, eds. Oxford Textbook of Palliative
Medicine. New York, NY: Oxford University Press, 2015: 447-56.
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Wilberg P, Hjermstad MJ, Ottesen S, Herlofson BB. Oral health is an important issue in end-of-life cancer care. Supportive Care in Cancer 2012; 20: 3115.
Article contributed by Palliative & Supportive Care
