title: Associations between oral complications and days to death in palliative care patients.
abstract: OBJECTIVE
  Adverse oral symptoms gradually appear in advanced cancer patients as the disease progresses. We retrospectively investigated the associations between the incidence of oral problems and the days to death (DTD) in patients receiving palliative care.
  
  
  METHODS
  The dental assessment sheets and medical charts of 105 patients who had been admitted into the palliative care unit at our hospital were examined. Case data included evaluations of organic and functional oral conditions at the time of admission for all patients. The cohort was divided into two groups according to the DTD as the short group (<28 days from the time of dental assessment until death) and the long group (≥28 days). We compared the incidences of organic and functional oral problems between these groups.
  
  
  RESULTS
  Dry mouth, tongue inflammation, and bleeding spots were significantly more frequent in the short group than in the long group (78 vs. 54% for dry mouth, 67 vs. 46% for tongue inflammation, 35 vs. 14% for bleeding spots, respectively; p < 0.05). Tongue coating and candidiasis were comparable between the two groups. Dysphagia was significantly more common in the short group (43%) than in the long group (20%) (p = 0.01), as was assistance with oral health care (76 vs. 50%) (p = 0.01).
  
  
  CONCLUSIONS
  Our findings suggest that, during palliative care, oral complications appear more frequently when the DTD period is shorter. These symptoms may be useful indicators when deciding on the proper timing of intensive oral care intervention to decrease oral problems and pain in terminally ill patients.
authors.affiliation: Department of Dentistry, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan. kmatsuo@fujita-hu.ac.jp.
authors.forename: K
authors.initials: K
authors.lastname: Matsuo
authors.affiliation: Department of Dentistry and Oral Surgery, Fujita Health University Hospital, Toyoake, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Watanabe
authors.affiliation: Department of Dentistry, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
authors.forename: D
authors.initials: D
authors.lastname: Kanamori
authors.affiliation: Department of Dentistry, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Nakagawa
authors.affiliation: Department of Dental Surgery, Fujita Health University Nanakuri Sanatorium, Toyoake, Japan.
authors.forename: W
authors.initials: W
authors.lastname: Fujii
authors.affiliation: Department of Nursing, Fujita Health University Hospital, Toyoake, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Urasaki
authors.affiliation: Department of Surgery and Palliative Medicine, Fujita Health University, Toyoake, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Murai
authors.affiliation: Department of Surgery and Palliative Medicine, Fujita Health University, Toyoake, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Mori
authors.affiliation: Department of Surgery and Palliative Medicine, Fujita Health University, Toyoake, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Higashiguchi
mesh_terms: D003422:Critical Care; D003643:Death; D005260:Female; D006801:Humans; D008297:Male; D009059:Mouth Diseases / Q000150:complications / Q000401:mortality*; D009369:Neoplasms / Q000150:complications*; D009909:Oral Health; D010166:Palliative Care / Q000379:methods*; D012189:Retrospective Studies
keywords: Dry mouth; Dysphagia; Oral care; Oral problems; Palliative care