Care of the Mouth

By: CVH Team

Many people with advanced illness experience significant mouth problems, which can affect their quality of life. Common problems include dry mouth, lips, and throat; open sores; yeast infections; or discomfort with dentures and partial plates. 

A regular mouth care routine helps keep the person comfortable, and ensures that medication given under the tongue can be properly absorbed. Provide mouth care three or four times a day, or more if the person requires it.
 

Everyday Mouth Care

• Continue to brush, floss, and rinse the mouth normally as long as possible. Use an ultra soft toothbrush and non-foaming toothpaste with fluoride.
   
• If normal brushing is not possible or the person is unconscious, use gauze or a cloth moistened with water to clean the mouth. Swab the inner surfaces of the mouth and tongue with a water-based mouth moisturizer gel.
   
• Continue to remove and clean dentures regularly. If the person has lost weight, dentures may not fit well anymore, causing discomfort. For this reason some people choose to leave their dentures out or wear them only for eating.
   
• Avoid lemon and glycerin mouth care products, which have been shown to cause dryness.
   
• Check the mouth regularly and tell health care providers about any noticeable changes such as bleeding, open sores or white patchy areas commonly associated with a yeast infection.
   
• Follow health care provider recommendations for treating yeast infections. If the person wears dentures, these also need to be treated daily during the treatment period. Soak dentures overnight in the antifungal prescribed as a mouth rinse (1 teaspoon of antifungal solution in enough water to cover dentures), or soak overnight in bleach solution (1 teaspoon bleach in 1 cup water). Please note: do not use a bleach soak if there is metal on the dentures or plate. Change the soaking solution daily.
   

Dry Mouth

• Moisten dry lips with a water-based moisturizing gel. Water-based moisture sprays are also available that can be used to moisten the mouth with a fine mist. Avoid petroleum- or alcohol- based mouth care products as they cause dryness.
   
• Refresh the mouth with regular rinses throughout the day. Options are club soda, mild salt solution (1/2 teaspoon salt mixed in 4 cups water) or mild bicarbonate solution (1 teaspoon baking soda mixed in 4 cups water).
   
• Some people like to suck on ice chips or chew sugar-free gum or candies to relieve a dry mouth.
   
• If the person is able to drink, keep liquids nearby at all times. If the person cannot safely swallow, do not give them fluids, as even small amounts of liquid can lead to choking.
   
• Avoid using a mouthwash that contains alcohol, which dries the mouth. Be sure to check commercial brands, as most do contain alcohol.
   
• If the person’s room is very dry, a humidifier may help relieve some of the dryness in the mouth.

See Video - Personal Hygiene - Helping with mouth care