30 October 2022

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Palliative oral health care in the context of dying with dignity

Mary Guiden

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In a commentary published in the Journal of the American Dental Association on Oct. 14, a team led by Dr. Frank Lobbezoo of the Academic Centre for Dentistry in Amsterdam called attention to a renewed focus in the country on dying and death. 

The authors cite a national campaign “Death. Talk about it, don’t change th subject,” launched in early 2022 from the Dutch advertising foundation SIRE. The campaign encourages people to reflect on the value of talking about death, with the idea that conversations about death connect people. 

In February 2022, the Lancet Commission on the Value of Death published its report “Bringing Death Back into Life.” The report highlighted that at one end of the spectrum, people in the last phase of their lives are overtreated in hospitals, with only a marginalized role in the support of the dying person by families and communities. At the other end of the spectrum, people die without any available palliative care. 

Systematic review of palliative patients

In a study published in BMC Oral Health in March 2020, researchers from the University of Brunei in Malaysia conducted a review of five databases and key journals, focusing on oral conditions of palliative patients published between 2000 to 2017. A high incidence of treatable oral conditions has been reported among palliative patients, according to the study.

The research team found that xerostomia, oral candidiasis and dysphagia were the three most common oral conditions among palliative patients, followed by mucositis, orofacial pain, taste change and ulceration. 

The authors said that despite the lack of study investigating palliative oral care among patients with dementia, geriatric or pediatric advanced cancer patients, the review provided baseline knowledge that may guide health care professionals in palliative settings.

Companies including Colgate provide advice and links to research about supportive dental procedures during palliative care. Family members seeking more information should consult their palliative care physician, who can refer a family to a dentist. Alternately, the patient's dentist may create a new care plan that supplements other palliative care treatments.

Read the JADA commentary on the journal’s website. 

Frank Lobbezoo, DDS et al. "The contribution of palliative oral health care to dying with dignity." JADA published Oct. 14, 2022. DOI:https://doi.org/10.1016/j.adaj.2022.08.015