Oral Hygiene and Dental Care Utilization in Palliative Care Patients

Objectives: Increased disease burden, polypharmacy, functional disability, and mental distress at the end of life can dramatically increase the risk of oral disease. Good oral hygiene and regular dental care are essential to improving oral health and maintaining quality of life. Unfortunately, there is no information regarding the oral hygiene behaviors and dental care patterns in persons receiving palliative care (PRPC) and how these patterns correlate with their oral health status. This study aimed to address this critical gap.
Methods: Forty-nine English-speaking PRPC, aged 18 years or older, were recruited from the University of Iowa Palliative Care Clinic. Participants were first interviewed regarding their oral hygiene practices (e.g., toothbrushing frequency, required assistance, and self-rated oral care skills) and dental care patterns (e.g., frequency of dental visits, time, and reasons for last visit). A brief oral examination was then given to assess PRPC’s oral health. Bivariate and multivariate analyses were utilized to determine the associations between oral hygiene practices, dental care patterns, and oral health outcomes.
Results: 49 participants averaged 58.4 years old. Among them, 57% were females and 67% had dental insurance. Nearly 60% brushed their teeth 2 or more times per day and their mean plaque score (0.70) and gingival score (0.92) were significantly less than those of the 40.3% who brushed their teeth once a day or less (plaque score=1.09, gingival score=1.17). Most participants utilized dental care regularly (46.9% had a dental visit within 6 months and 20.4% had one 6-12 months ago). Nearly one-third (30.6%) last visited a dentist over a year ago. These individuals had significantly more decayed/broken teeth than those with a dental visit within the past 6 months (1.67 vs. 1.19, P=0.03).
Conclusions: Despite terminal illness, most PRPC still valued their oral hygiene and utilized dental care regularly, lowering the risk of oral disease.