Associations between oral complications and days to death in palliative care patients

K. Matsuo, R. Watanabe, D. Kanamori, K. Nakagawa, W. Fujii, Y. Urasaki, M. Murai, N. Mori, T. Higashiguchi

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. 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. 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). 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.