The role of dentistry in palliative care of the head and neck cancer patient.
Although palliative care for the terminally ill is based on a multidimensional philosophy to provide whole-person comfort care while maintaining optimal function, it does not usually include dentistry in its team approach. Dentists can have a significant role in the care of these patients by providing total, active comfort care of the oral cavity. The function of the oral cavity is essential to the patient's ability to thrive. Therefore, alleviation of pain and prevention of infection in the oral cavity should be a priority in providing total, active comfort for the patient. The oral problems experienced by the hospice head and neck patient clearly affect the quality of his or her remaining life. Through routine assessments and interventions by a dentist on the palliative care team (Figure 4), comfort care for the patient may be improved by the maintenance of oral hygiene and procedures to hydrate the oral mucosa. In addition, routine dental assessments may identify dental disease and facilitate dental interventions for caries, periodontal disease, oral mucosal problems or prosthetic needs. Attention to such detail may reduce not only the microbial load of the mouth but the risk for pain and oral infection as well. This multidisciplinary approach to palliative care, including a dentist, may reduce the oral debilities that influence the patient's ability to speak, eat or swallow. Not only does maintenance of oral health have impact on the quality of life, which is already challenged by the disease, but it also aids in the ability of patients to thrive for whatever precious time is left to them.
Paunovich
E D
ED
Oral Health Programs for Special Care Patients, Geriatrics and Extended Care, South Texas Veterans Health Care System, University of Texas Health Science Center at San Antonio, USA.
Aubertin
M A
MA
Saunders
M J
MJ
Prange
M
M
D001424:Bacterial Infections / Q000517:prevention & control; D002180:Candidiasis, Oral / Q000517:prevention & control; D003679:Deglutition / Q000502:physiology; D017742:Dental Care for Chronically Ill; D017266:Dental Prosthesis / Q000009:adverse effects; D003815:Dentists; D004435:Eating / Q000502:physiology; D005157:Facial Pain / Q000517:prevention & control; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D009059:Mouth Diseases / Q000517:prevention & control; D009752:Nutritional Status; D009910:Oral Hygiene; D019226:Oral Ulcer / Q000517:prevention & control; D010166:Palliative Care; D010348:Patient Care Team; D011788:Quality of Life; D013060:Speech / Q000502:physiology; D013727:Terminal Care; D014987:Xerostomia / Q000517:prevention & control