A Narrative of Oral Care in Palliative Patients

Kvalheim, Siri Flagestad; Strand, Gunhild Vesterhus

doi:10.3390/ijerph19106306

Cited by 8 publications

(10 citation statements)

References 26 publications

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“…There are many challenges in providing care for cachexic, terminally ill, debilitated patients. Oral problems affects the whole organism (1). The dentist should aim to reduce pain from the oral cavity and ensure sufficient dental function.…”

Section: Discussionmentioning

confidence: 99%

“…Palliative care is an approach that encompasses procedures to relieve pain, distressing symptoms and maintain function as much as possible in the sick or elderly, including in life-threatening illness (cancer, chronic heart failure, chronic obstructive pulmonary disease, cognitive impairment, physical restrictions, etc.) (1). The field of palliative care is considered the most interdisciplinary of medical specialties, as it includes spiritual issues in addition to medical ones.…”

Section: Introductionmentioning

confidence: 99%

“…However, dental professionals are often absent. Oral changes in these patients are among the most common problems (1). A major reason for the involvement of a dental practitioner is that oral health and oral hygiene are important for good general health.…”

Section: Introductionmentioning

confidence: 99%

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Oral Palliative Care: А Review

Panov¹

2022

MedInform

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Palliative care is active comprehensive care for patients whose illness does not respond to treatment. Palliative care specialists deal with patients in the terminal stage of illness or aging. Palliative care is an approach that encompasses procedures to relieve pain, distressing symptoms and maintain function as much as possible in the sick or very elderly, including in life-threatening illnesses. The field of palliative care is considered the most interdisciplinary of all medical specialties.Oral care is important for all people and should be considered as a part of daily medical care. Palliative care dentistry focuses on the treatment of sick patients where the oral cavity is directly or indirectly affected by the disease. Regular examinations and oral hygiene should be started early in palliative care patients to optimize comfort and prevent more serious complications. The dentist should help to reduce pain from the oral cavity and ensure sufficient dental function, must establish and treat the main complaints, propose an oral hygiene plan to the patient, medical staff or relatives.Palliative care patients and their caregivers often neglect oral problems and the need for oral hygiene, resulting in many daily difficulties that include difficulty chewing, dry mouth, risk of infection and inflamations, bad breath and nutrition, changes in taste, which ultimately impair their quality of life.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Oral Palliative Care: А Review

Panov¹

2022

MedInform

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“…Notably, a signi cant proportion of participants had substantial, unmet oral health needs. Previous studies have highlighted that the prevalence of oral health conditions amenable to treatment (e.g., dry mouth, mucositis, candidiasis) among people with life-limiting illness can be as high as 90% (43)(44)(45).…”

Section: Policy Implicationsmentioning

confidence: 99%

Primary data on symptom burden and quality of life among elderly patients at risk of dying during unplanned admissions to an NHS hospital: a cohort study using EuroQoL and the Integrated Palliative Care Outcome Scale

Johnston,

Miller,

Normand

et al. 2023

Preprint

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Background Older people account heavily for palliative care needs at the population level and are growing in number as the population ages. There is relatively little high-quality data on symptom burden and quality of life, since these data are not routinely collected, and this group are under-recruited in primary research. It is unclear which measurement tools are best suited to capture burdens and experience. Methods We recruited a cohort of 221 patients aged 75 + years with poor prognosis who had an unplanned admission via the emergency department in a large urban hospital in England in 2019 and early 2020. Risk of dying was assessed using the CriSTAL tool. We collected primary data and combined these with routine health records. Baseline clinical data and patient reported quality of life outcomes were collected on admission and reassessed within the first 72 hours of presentation using EQ-5D-5L, EQ-VAS and the Integrated Palliative Outcomes Scale (IPOS). Results Completion rate was 68% (n = 151) and 33.1% were known to have died during admission or within 6 months post-discharge. The vast majority (84.8%) reported severe difficulties with at least one dimension of EQ-5D-5L at baseline and improvements in EQ-VAS observed at reassessment in 51.7%. The baseline IPOS revealed 78.2% of patients rating seven or more items as moderate, severe or overwhelming, but a significant reduction (-3.6, p < 0.001) in overall physical symptom severity and prevalence was also apparent. No significant differences were noted in emotional symptoms or changes in communication/practical issues. IPOS total score at follow up was positively associated with age, having comorbidities (Charlson index score > = 1) and negatively associated with baseline IPOS and CriSTAL scores. Conclusion Older people with poor prognosis admitted to hospital have very high symptom burden compared to population norms, though some improvement following assessment was observed on all measures. These data provide valuable descriptive information on quality of life among a priority population in practice and policy and can be used in future research to identify suitable interventions and model their effects.

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“…Symptoms such as xerostomia, candidiasis, mucositis, stomatitis, ulceration, and taste alterations are often present [1][2][3][4][5]. Aside from an increased risk of dental caries, infections, and osteoradionecrosis, xerostomia can cause oral difficulties such as discomfort, dysphagia, speech difficulty, altered or diminished taste, and osteoradionecrosis.…”

Section: Introductionmentioning

confidence: 99%

Xerostomia care in palliative patients: a scoping review protocol

Coelho,

Marques,

Neves

et al. 2023

Preprint

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Background Oral problems are very common in palliative patients and have a huge impact on the quality of life of patients and families. A common complication in these patients and one of the most prevalent and significant problems is xerostomia. Xerostomia influences the taste and tolerance of some foods impacting the appetite and the ability to talk and social interaction, inducing distress. In this context, healthcare professionals should promote oral care to relieve and control symptoms to comfort palliative patients. This study aims to map the literature on how patients receiving palliative care are treated for xerostomia. Methods Scoping review will be carried out according to Joanna Briggs Institute methodology. A set of relevant electronic databases and grey literature will be searched. This scoping review will consider any quantitative, qualitative, mixed-methods study and systematic review designs for inclusion, focusing on how palliative care patients are treated for xerostomia. Conclusion This scoping review will be the first to map evidence on xerostomia in palliative patients, specifically how to diagnose and treat these patients. Moreover, the review will also take a wide variety of healthcare settings, interventions and their characteristics, and study designs into account.

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A Narrative of Oral Care in Palliative Patients

Cited by 8 publications

References 26 publications

Oral Palliative Care: А Review

Oral Palliative Care: А Review

Primary data on symptom burden and quality of life among elderly patients at risk of dying during unplanned admissions to an NHS hospital: a cohort study using EuroQoL and the Integrated Palliative Care Outcome Scale

Xerostomia care in palliative patients: a scoping review protocol

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