Waikato DHB Palliative Care Guidelines

10. Dry mouth

• Oral candida must be excluded and if present treated with nystatin oral suspension, Mycostatin™  or miconazole gel. Parenteral antifungals e.g. fluconazole may be necessary for severe cases or when oesophageal candida is suspected.
  
  
• Attention to mouth cares and moistening is very important especially in the terminal phase when oral intake is reduced – this includes ice to suck, sips of water and swabs moistened with water applied to mouth and lips.
  
  
• Lemon and Glycerine swabs should NOT be used as the acidity causes mouth problems after short periods of use. USE jumbo swabs moistened with fluids as desired by patient.
  
  
• Saliva Substitutes are available but are of limited value.
  
  

10.1 Oral care

• Soda Bic mouthwashes qid are often effective (1tsp Baking Soda dissolved in water) or soda Bic  impregnated mouth swabs.
  
  
• Diluted Difflam™ mouthwashes to assist with oral hygiene.
  
  
• Soda Bic and water may be helpful for a severely coated tongue.
  
  
• Brush tongue gently with a soft toothbrush.
  
  
• Remember to sterilize dentures.