*2.4.3 Mucositis*

This typically presents as dry, burning, and/or reddened tissues. It is by advisable to discontinue spicy, minty or cinnamon-containing foods and oral care products.

**73**

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

A liquid mixture for swabbing around the mouth after meals and before bedtime can be prescribed by a dental or medical professional. It consists of three equal parts of Benadryl (if tolerable), milk of magnesia, and xylocaine viscous, and can be

• use of a soft bristled toothbrush and non-irritating toothpaste (one without sodium laurel sulfate detergent and which does not contain spicy or irritating

• Removal of dentures except when needed for consumption of food.

• Soaking dentures twice a day in a 1:1 ratio of vinegar and water in solution.

If redness and pain are unresolved within seven days, consult a dentist; a treat-

Often times, especially in those with poor diabetic control issues or in those using antibiotics, a fungal coating, typically white, can form on the tongue, throat, and other parts of the mouth. This "opportunistic" infection is called *Candida albicans*, and can cause a burning sensation within the mouth as well as at the corners of the lips; a palliative prescription can be administered for an antifungal

To treat the tissues, dentures must be removed during medication application to the oral tissues, and topical agents may be used on the dentures themselves. Sponge swabs maybe used to apply the medications for hospice patients who may be unable

Systemic agents including ketoconazole, fluconazole, and/or amphotericin B may be required for severe or intractable cases. Candidiasis may be treated according to

• Nystatin suspension 100,000 IU (5 ml = 1tsp) four times daily for 1 to 2 weeks. The medication is to be held in the mouth for one minute, with a swish and swallow approach. An oral sponge may be employed if rinsing is not possible. This is the first choice of therapy if a patient is unable to safely hold a tablet/troche in

This is to be used five times daily for two weeks. This is the first choice of therapy if a patient is able to hold the tablet in the mouth without risk of aspiration.

• Fluconazole tablets 100 mg. This is to be taken as two stat, then once daily for two weeks. This is preferable for moderate to severe cases or if topical treat-

• Dentures may be soaked overnight in a few drops of Nystatin suspension

mixed into a cup of cool or room temperature water.

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

easily compounded by any pharmacy.

components).

*2.4.4 Candidiasis*

A therapeutic regimen may consist of the following:

• Replacement of toothbrushes weekly until healed.

• Rinsing with a sterile saline as needed.

ment for Candidiasis (thrush) may be necessary.

medication by a dental or medical professional.

• Clotrimazole troches 10 mg per troche

severity by one or more of the following medicinal agents:

to rinse with liquid suspensions.

the mouth.

ment is impractical.

## *Why Are We Missing the Teeth? Addressing Oral Care Neglect in the Palliative Patient DOI: http://dx.doi.org/10.5772/intechopen.95606*

A liquid mixture for swabbing around the mouth after meals and before bedtime can be prescribed by a dental or medical professional. It consists of three equal parts of Benadryl (if tolerable), milk of magnesia, and xylocaine viscous, and can be easily compounded by any pharmacy.

A therapeutic regimen may consist of the following:


If redness and pain are unresolved within seven days, consult a dentist; a treatment for Candidiasis (thrush) may be necessary.
