Table 2.

Common oral problems in palliative patients

Oral lesion/condition	Features	Causes
Xerostomia	Dry mouth	Anxiety, and depression
	Coated tongue	Drugs (side effects): Antimuscarinics, diuretics
	Tongue may appear glossy	Mouth breathing, un-humidified oxygen, infection
	Salivary gland hypo function	Dehydration, restricted diet/fluid intake
		Surgery, chemotherapy or radiotherapy to the head and neck region
		Injury to salivary glands or buccal mucosa
		Hypothyroidism, Autoimmune disease like Sarcoidosis, Jorgen's syndrome and Alzheimer's disease etc.
Oral candidiasis	Creamy white patches	Prolonged antibiotics
	Multiple white to yellow soft plaques	Diabetes mellitus
	Areas may bleed and burn	Impaired immunity (e.g. chemotherapy/radiotherapy)
	Taste alterations	Dry mouth
	Usually accompanied by xerostomia	Prolonged wearing of dentures
Angular cheilitis	Cracking, fissuring, irritation with red areas at mouth corners	A fungal or bacterial infection most often associated with denture stomatits
	Painful mouth opening	A vitamin B deficiency
Denture stomatits	Generalized redness in upper palate (rarely lower palate)	Denture not cleaned properly and dentures that remain in mouth for longer period of time
	Chronic irritation and redness	A fungal or bacterial infection
	Mostly asymptomatic but sometimes painful and may bleed
Mucositis	Inflammation and bleeding of the oral soft tissues of lips, cheeks, gums, and tongue	Mucositis is mouth pain that develops due to the break down of oral tissues
	Pain, nutritional problems, and increase risk of infections
Dysphagia	Inability to hold or control food	Weakened musculature and control over facial muscles and tongue
	Pocketing of food	Sensation loss
	Incompetent lips	Patient continually lie in a flat or reclined position
	Higher risk for choking food etc.
Ulceration	Apthous ulcers (canker sores)	Medications
	Crater type sore or mucous membrane	Nutritional deficiency
	Painful	Stress
	Interference with speech and swallowing	Acidic food
	Sometimes pus formation	Trauma
Taste disorders	Taste alterations	Depression
	Decreased taste sensitivity	Head and neck radiotherapy
	Sometimes burning sensation	Medications for diseases like diabetes, depression, anti Parkinson, seizures etc.
Sore/dry lips	Lip tissues are flaking and rough	Dehydration of lips and pores blockage