Good mouth care is crucial. Mouth problems are very uncomfortable and can have a negative impact on someone’s quality of life, including their ability to eat, speak and swallow.
Mouths easily become sore and dry with advancing illness, and especially after repeated antibiotics and chemotherapy.
Top tips on mouth care
- Keep the mouth and lips clean and moist if possible
- Ideally provide mouth care when the person is semi-upright, to avoid choking. If that’s not possible, make sure fluid isn’t building up in their mouth as you give mouth care
- Brush teeth twice a day, and use a very soft toothbrush for a sore mouth - childrens tootbrushes and toothpaste may help. Use a non-foaming toothpaste for people who have difficulty swallowing
- Take out and clean dentures or dental plates at least once a day and rinse them after eating
Dry mouth
- Encourage regular sips of water or other favourite cold drinks. A small plant sprayer might help
- Suck on ice cubes (perhaps made from a favourite drink), ice chips or ice lollies
- Chew gum or suck on sweets to stimulate the production of saliva - as long as there is no choking risk
- Moisturise lips with lip balm or a water-based gel such as Oralieve or KY-Jelly.
- It is best to avoid petroleum-based jelly such as Vaseline as these can be drying. (Vaseline and petroleum products are also best avoided if on oxygen therapy as this can be a fire hazard).
- Ask the doctor, nurse or pharmacist about saliva substitute sprays and gels
- Ask the doctor or nurse to review medications as many medicines dry up saliva
Sore mouth
- Avoid acidic foods such as citrus foods (e.g. lemons, oranges) and vinegar (pickles) and very spicy foods (e.g. curry)
- Try drinking through a straw to stop liquids coming into contact with the sorest part of your mouth
- Soothe the mouth with cold soft foods like custard, yoghurt, ice cream and jelly
- Allow hot food to cool down a little before eating
- Try softer foods like porridge, pasta or fish with a sauce, egg dishes and milky puddings
- Add gravy or sauces to moisten food
- Avoid dry foods like biscuits, toast and crisps, but if these are enjoyed, chew them well and have plenty to drink
- Ask the doctor, nurse or pharmacist about mouthwashes and painkillers. Salt water is a good mouthwash - just add half a teaspoon of salt to a cup of warm water
When to ask for more help
A defined area of soreness, redness or white patches may be a sign of infection (e.g. thrush or cold sores) which may need medication.
Let the doctor or nurse know if mouth problems mean that swallowing pills is difficult so that liquid or soluble painkillers can be prescribed. Liquid food supplements may help if it is too painful or difficult to eat solid food.
Dental visits or home dental visits can be very helpful if you are able to access these.
The video below from Hospice in the Weald demonstrates how to gently clean and moisturise someone's mouth towards the end of life