palliative care and the mouth; oral problems in palliative care

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Palliative Care and Palliative Care and the Mouth; Oral the Mouth; Oral Problems in Palliative Problems in Palliative Care Care Emma Riley Emma Riley Macmillan Oral Health Macmillan Oral Health Practitioner Practitioner

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Palliative Care and the Mouth; Oral Problems in Palliative Care. Emma Riley Macmillan Oral Health Practitioner. Palliative care. ‘…the active holistic care of patients with advanced, progressive illness. Management of pain and other symptoms and provision of psychological, social and - PowerPoint PPT Presentation

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Page 1: Palliative Care and the Mouth; Oral Problems in Palliative Care

Palliative Care and the Mouth; Palliative Care and the Mouth; Oral Problems in Palliative Oral Problems in Palliative

CareCare

Emma RileyEmma RileyMacmillan Oral Health PractitionerMacmillan Oral Health Practitioner

Page 2: Palliative Care and the Mouth; Oral Problems in Palliative Care

Palliative carePalliative care‘…‘…the active holistic care of patients with advanced,the active holistic care of patients with advanced,progressive illness. Management of pain and otherprogressive illness. Management of pain and other

symptoms and provision of psychological, social andsymptoms and provision of psychological, social andspiritual support is paramount. The goal of palliative carespiritual support is paramount. The goal of palliative careis achievement of the best quality of life for patients andis achievement of the best quality of life for patients andtheir families. Many aspects of palliative care are alsotheir families. Many aspects of palliative care are also

applicable earlier in the course of the illness in conjunctionapplicable earlier in the course of the illness in conjunctionwith other treatmentswith other treatments

Page 3: Palliative Care and the Mouth; Oral Problems in Palliative Care

Palliative Care does not Palliative Care does not mean end of lifemean end of life

When a patient is end of life they When a patient is end of life they can be placed on the LCPcan be placed on the LCP

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Mouth care maintains:Mouth care maintains:

Self-esteemSelf-esteem ComfortComfort Person’s ability to communicatePerson’s ability to communicate SocialiseSocialise Enjoy food and drinksEnjoy food and drinks

Page 5: Palliative Care and the Mouth; Oral Problems in Palliative Care

ORAL HYGIENE CAREORAL HYGIENE CARE

A clean and infection clear mouth A clean and infection clear mouth is a is a BASIC NEEDBASIC NEED..

Heals(1993)states that a patients Heals(1993)states that a patients oral status is a good indication of oral status is a good indication of

the care receivedthe care received

Page 6: Palliative Care and the Mouth; Oral Problems in Palliative Care

AssessmentAssessment Identify patients at risk of oral problems and plan Identify patients at risk of oral problems and plan

mouthcare: mouthcare: radiotherapy/chemotherapy, Enteral fed, radiotherapy/chemotherapy, Enteral fed,

dysphagia, immunocompromised, oxygen and dysphagia, immunocompromised, oxygen and terminally ill.terminally ill.

Drug history:Drug history: Antichloinergics(e.g. hyoscine) – increase dry Antichloinergics(e.g. hyoscine) – increase dry

mouth.mouth. Bisphosponates-risk of osteonecrosis of the Bisphosponates-risk of osteonecrosis of the

jaw, especially if oral/dental health is poor.jaw, especially if oral/dental health is poor.

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AssessmentAssessmentExamine thoroughly with a torch and a Examine thoroughly with a torch and a

tongue depressor.tongue depressor. Remove dentures, avoid painful lips by Remove dentures, avoid painful lips by lubricating. Assess for dryness, coating, lubricating. Assess for dryness, coating,

ulceration or tooth decay. Assess for pain.ulceration or tooth decay. Assess for pain.

Document findings accurately and assess Document findings accurately and assess oftenoften

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Helping the symptomsHelping the symptoms

Acknowledge that there is Acknowledge that there is a problem, don’t just see a problem, don’t just see it as “par for the course”it as “par for the course”

Maintain good oral Maintain good oral hygiene.hygiene.

Try one of the various Try one of the various products available.products available.

Reassess to see if there Reassess to see if there has been any has been any improvement.improvement.

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ToothbrushesToothbrushes

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ToothpastesToothpastes

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SwabsSwabs

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EDENTULOUS PATIENTSEDENTULOUS PATIENTS

GENTLY RETRACT CHEEKS AND WITH GENTLE GENTLY RETRACT CHEEKS AND WITH GENTLE STROKES BRUSH INSIDE SURFACESSTROKES BRUSH INSIDE SURFACES

USING GAUZE HOLD THE TONGUE AND GENTLY USING GAUZE HOLD THE TONGUE AND GENTLY BRUSH REAR TO FRONTBRUSH REAR TO FRONT

GENTLY BRUSH PALATEGENTLY BRUSH PALATE ASPIRATE IF AIRWAY IS AT RISKASPIRATE IF AIRWAY IS AT RISK

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DENTURESDENTURES

BRUSH WITH WATERBRUSH WITH WATER PAYING ATTENTION TO THE CLASPSPAYING ATTENTION TO THE CLASPS RINSE WELLRINSE WELL SALIVA SUBSTITUTE MAY BE USED BEFORE SALIVA SUBSTITUTE MAY BE USED BEFORE

REPLACING DENTURE IN THE MOUTHREPLACING DENTURE IN THE MOUTH

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Quality of LifeQuality of Life

And finallyAnd finally

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