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Caring for your loved one - Oral Care

Brochures; Caregiver Tips

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

  1. Ora​l 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

  1. ​Xerosto​mia
  • ​Subjective sensation of dryness of mouth
  • ​Possible causes: mouth breathing, oxygen use, certain medications e.g. opioids
  1. 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

  1. Halitosis
  • ​Bad breath
  • Possible causes: poor oral hygiene, dry mouth, coated tongue​

Mouth care in the last hours of life

  • 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

  1. 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.
  2. 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.
  3. 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

Health Tip; Brochure

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