Oral Hygiene In Dying Patients With Diminished Consciousness

Xerostomia (subjective sensation of oral dryness) and stomatitis (sore mouth) are common in patients with terminal disease and have considerable impact on patients' wellbeing. Patients with diminished consciousness may still be aware of oral discomfort such as a dry mouth. Therefore, good oral hygiene is an important nursing role when caring for terminally ill and dying patients. However, in terminally ill and dying patients who are semi-conscious or unconscious, oral care is often based on historical anecdote rather than robust research evidence and nurses often lack knowledge about the most effective care practices. This article will make recommendations for clinical practice to support nurses or healthcare assistants when carrying out oral care on patients who are at the end of life and are semi-conscious or unconscious. It will consider the evidence for the effectiveness, appropriateness and patient acceptability of oral-cleansing substances, toothbrushes and foam swabs, petroleum jelly and water-based gels for dry lips, topical saliva stimulants and saliva substitutes, as well as topical treatments for stomatitis. Conflicts of interest: none