Mouthcare

Good basic mouthcare is a fundamental element of good care in the final days of life. It can have a significant impact on their comfort, as studies show that dry lips and mouth are more likely to cause a sensation of thirst when oral intake is reduced. Mouthcare can also be an area of care with which families and carers can help. 

General principles

• Keep mouth and lips clean and moist with sponges, sprays, or ice chips
• Clean teeth and dentures regularly
• Help patients have frequent, small drinks if able
• Apply lip salve to dry lips (NB petroleum-based gels such as Vaseline are not recommended with oxygen use)
• Aim to provide mouthcare with patients in an upright position to reduce the risk of choking or aspiration
• Moist foods can be sucked for flavour and discarded

For those with their own teeth

• Clean teeth with fluoride toothpastes 
• Use soft bristled brushes
• Not rinsing after brushing can protect teeth but is drying and uncomfortable so rinsing should be encouraged
• Avoid foaming toothpastes if patient has swallowing difficulties

For patients with dentures

• Check whether the patient would prefer to have them in or out
• Remove dentures at night to soak and risk before replacing
• Brush dentures once daily when in use
• Rinse thoroughly after food
• Check the fit of the dentures as this may change rapidly and drastically in the final days