The focus on dying and death has been revived. The Lancet Commission on the value of death states that dying and death should be recognised as normal and, especially, meaningful: there is no life without death. To this end, end-of-life care ought to be available to all, with a shift in health-care focus from disease to person, from longevity to wellbeing, and from institutions to communities.
The Lancet Commission on Palliative Care and Pain Relief Study Group recommended that all medical professionals ought to have general competencies in palliative care. Oral care is extremely important for wellbeing. As such, it is surprising to us that oral care is not mentioned at all in these Lancet Commissions.
Many people reaching the end of their lives are afflicted by debilitating oral conditions such as mucositis, pulpitis, and abscesses. Dry mouth and pain, two common effects of these conditions, can make eating difficult. Poor oral health might be associated with halitosis, which impairs essential social interactions between the person dying and their loved ones.
We therefore take the stand that oral care should be a part of palliative care worldwide. It is our ambition to help disseminate and implement this notion. Importantly, oral care should be achieved in the spirit of the Lancet Commission on the value of death, which advocates for a focus on people, wellbeing, and community. As such, palliative oral care will contribute to people dying well.
References:
Report of the Lancet Commission on the Value of Death: bringing death back into life.
This article was published on June 11, 2022. For details and to download a PDF follow this link.
Lancet.2022; 399: 837-884
I think it would be an obvious conclusion that part of the solution is to hire the appropriate caregiver to help people keep their mouth clean and comfortable. i believe dental hygienists should be recognized as the rational and reasonable oral health provider , who could become an integral part of the circle of care. With the incorporation of dental hygiene oral care, people can have fresh breath and healthier gums. When a natural death is approaching, the dental hygienist can maintain the oral cavity, with a focus on maintenance, not restorative and curative. The asymptomatic and painless aspects of aged teeth do not require restorative interventions. Dental Hygienists could be instrumental in addressing a extended life and peaceful end. This approach to care is influential as it helps prevent the effects of oral disease on overall health!