This article explains mouth care for people in palliative care and at the end of life.

  • Mouth care stops pain and infection. It keeps the person comfortable and helps them eat, drink and talk.
  • Palliative care can last a long time. Keep up daily cleaning.
  • A clean mouth and fresh breath help the person stay close to family and friends.

Comfort and dry mouth

  • Give small sips of water often.
  • Ice chips can help if the person can swallow or spit.
  • If the person is unconscious or cannot have a toothbrush: wet some gauze (the kind that does not fray) in clean water. Wrap it around your gloved finger and wipe the mouth.
  • Use a water-based lip balm often.
  • Use dry mouth gel (for example Oral 7). It is safe to swallow. It can also go under dentures instead of denture glue.
  • If the person can spit, use a dry mouth rinse. Or make one: 3 g of bicarbonate of soda in 50 ml of water. Rinse and spit. Do not swallow.

Brushing

  • Brush twice a day with a soft or extra-soft brush.
  • Use a low-foam fluoride toothpaste. Mild or no flavour is less likely to sting.
  • For very sore mouths, use an ultra-soft brush.

Dentures

  • Clean dentures twice a day with liquid soap and a denture brush (or a HyGenie). Rinse them after meals.
  • Take dentures out at night. Store them dry.

Ulcers and sore spots

  • Mouth sores can be very painful. They can stop a person eating and talking.
  • Causes include sharp broken teeth, rubbing dentures and illness.
  • A dental professional can adjust dentures, or leave them out so the mouth can heal.

Thrush (fungal infection)

  • Signs: redness, often under dentures, or a white coating that wipes off to show red skin.
  • Risks: dry mouth, antibiotics, dirty mouth or dentures, weak immune system.
  • A doctor or dentist should prescribe treatment. Keep the mouth clean and moist.

Do NOT use

  • Petroleum or glycerin lip balms (like Vaseline) if the person is on oxygen. They are a fire and burn risk. Use water-based only.
  • Lemon, citrus or juice to make saliva. The acid stings and damages teeth.
  • Strong mouthwashes like Listerine, Savacol or ones with alcohol. They sting a dry mouth.