**3. Conclusion**

Oral care is an important component of institutionalized healthcare for the dependent and terminal because:


**79**

*Why Are We Missing the Teeth? Addressing Oral Care Neglect in the Palliative Patient*

giver's simply assisting with or treating dental maladies.

while demonstrating that improving one's palliation goes beyond the care-

• Appropriate oral care delivered adequately and expediently, will enhance the hospice patient's quality of life through a more esthetic and comfortable

• This will include one's experiencing enhanced socialization, more pleasurable eating and drinking, freedom from pain and discomfort, and an enhanced

• Further, this will prevent medical problems such as bacteremia, aspiration

• It will also help to manage patient complaints such as halitosis (bad breath), speech problems, dysphasia (trouble eating), and an inability for maintaining

• It will help to manage consequences from comorbid medical conditions such as

The most generous detail about delivering -and receiving-palliative care is that it focuses a great deal on kindness, and not so much on clinical perfection. There is really no general standard of care, as each individual is unique in his or her tolerance, basic needs, and willingness to allow intervention. Responsibilities as mentioned for facilities and dental providers in serving the terminally ill can certainly appear a bit daunting, yet palliative care only requires a caregiver to offer the best therapy possible in light of any situation that may exist. It is not so linked to stipulations and mandates, but rather to heartfelt compassion and a well-intended effort to soothe and comfort a

Dentistry has long been absent in the role played in delivering such care, and as such, personal dignity and the sense of well-being aided by oral maintenance are concomitantly remiss. Dentists must step up to avail to caregivers in both institutions and at home a more well-understood prescriptive program for oral care that can be implemented at the various stages of need for end-of-life patients. Further, collaborative efforts among dentists, physicians, institutions, and their respective staff members must be strengthened to assure that care of the oral cavity does not

Finally, increased awareness to address these issues must begin in dental and medical schools, as students should learn early on about elder care, volunteerism, and advocacy. Without advances in oral care management of the infirmed and terminal, the void in these patients' receiving comprehensive systemic and psychological palliation will increase as the percentage of the elderly continues to rise.

Sjogren's syndrome, arthritis, strokes, radiation, and chemotherapy.

*DOI: http://dx.doi.org/10.5772/intechopen.95606*

experience of well-being.

ability to communicate verbally.

adequate nutrition and hydration.

person both physically and psychosocially.

continue to go unattended.

pneumonia, and poor diabetic control issues.

• Patient oriented outcomes with a focus on quality of life can enhance our understanding of the relationship between oral health and general health, while demonstrating that improving one's palliation goes beyond the caregiver's simply assisting with or treating dental maladies.


The most generous detail about delivering -and receiving-palliative care is that it focuses a great deal on kindness, and not so much on clinical perfection. There is really no general standard of care, as each individual is unique in his or her tolerance, basic needs, and willingness to allow intervention. Responsibilities as mentioned for facilities and dental providers in serving the terminally ill can certainly appear a bit daunting, yet palliative care only requires a caregiver to offer the best therapy possible in light of any situation that may exist. It is not so linked to stipulations and mandates, but rather to heartfelt compassion and a well-intended effort to soothe and comfort a person both physically and psychosocially.

Dentistry has long been absent in the role played in delivering such care, and as such, personal dignity and the sense of well-being aided by oral maintenance are concomitantly remiss. Dentists must step up to avail to caregivers in both institutions and at home a more well-understood prescriptive program for oral care that can be implemented at the various stages of need for end-of-life patients. Further, collaborative efforts among dentists, physicians, institutions, and their respective staff members must be strengthened to assure that care of the oral cavity does not continue to go unattended.

Finally, increased awareness to address these issues must begin in dental and medical schools, as students should learn early on about elder care, volunteerism, and advocacy. Without advances in oral care management of the infirmed and terminal, the void in these patients' receiving comprehensive systemic and psychological palliation will increase as the percentage of the elderly continues to rise.

*Suggestions for Addressing Clinical and Non-Clinical Issues in Palliative Care*

• Brush the patient's tongue and wipe the oral tissues (cheeks, palate, and under the lips); coconut oil can provide a nice-tasting and lubricating medium.

*2.4.13 Care of the Oral Tissues (tongue, cheeks, inside and outside of lips, floor and* 

This can be accomplished either by rinsing (where the patient is capable), or by wiping the mouth with a lubricating substance, such as a saliva substitute or

Take care not to choke patients with hasty or over-abundant use of these

Oral care is an important component of institutionalized healthcare for the

• The demographic of older adults who are entering hospice care is growing and likely will continue to constitute an increasingly larger populous engaged with

• The comorbidities and physiological changes associated with these aging individuals make them more vulnerable to oral health problems.

• With aging comes the use of multiple prescriptive and over-the-counter medications, causing a potential rise in medication errors, drug interactions, and adverse drug reactions, all of which are important in oral care considerations, particularly where local anesthetics and analgesics are concerned.

• The physical, sensory, and cognitive impairments often seen in this group may create challenges both with oral health self-care as well as with patient educa-

• Dental conditions associated with the aging mouth can include xerostomia (dry mouth), root and coronal caries (decay), and periodontal (gum)

• Oral health related quality of life is a multi-dimensional concept which considers the totality of the patient's oral health, functional well-being, emotional

well-being, expectations and satisfaction with care, and sense of self.

• Patient oriented outcomes with a focus on quality of life can enhance our understanding of the relationship between oral health and general health,

coconut oil placed on either a piece of gauze or a toothette sponge.

• Palliative care and dental health go hand-in-hand.

These tissues should be cleaned anytime the teeth and/or dentures are cleaned.

• Use cool or slightly warm water.

• Reinsert the dentures.

• Apply lip moisturizer.

*roof of the mouth)*

dependent and terminal because:

end-of-life caregiving.

tion and communication.

disease.

substances.

**3. Conclusion**

**78**

*Suggestions for Addressing Clinical and Non-Clinical Issues in Palliative Care*
