Table 1.

Procedures for oral care in palliative patients, prepared by a group from the Regional Centre of Excellence for Palliative Care, Norway (translated into English by the authors of this article).

Oral Care for Palliative Patients—The Short Version
If the Patient Is Unconscious, Dentures Must Always Be Removed. Special Care Must Be Taken When Oral Care Is Carried Out
Item to Be Considered	Instruments/Products	Oral Care Procedures
Hygiene, general measures	Gloves—non-sterile	Hand cleaning is performed before and after the oral care procedure. Oral care is a clean procedure, but sterile gloves are usually not required. Procedures must be individualized.
Preparation, before procedures	Mouth mirror or spatula, light or torch (flashlight), gloves, disposable kidney bowl, towel/paper	Inform patient. Position patient as well as possible to complete the oral care procedure.
Oral assessment	Oral assessment form ROAG (The Revised Oral Assessment Guide)	Examine lips, tongue, teeth, gums, and mucous membrane. Examine signs and symptoms from the oral cavity, routinely and systematically. Should be carried out at admission, thereafter when needed. Record findings in journal.
Lubrication of lips	White Vaseline or water-based lip cream	Always start and end with lip lubrication.
Cleaning of teeth and mucous membranes	Soft toothbrush with small head, preferably electric toothbrush. Toothpaste with neutral soap, small amount. Lockable tweezers with gauze. Hydrogen peroxide 0.5% (hydrogen peroxide 3% 15 mL in 75 mL water); alternatively, NaCl 9 mg/mL.	Clean teeth, tongue, and oral mucosa. Dentures must be removed and cleaned. After brushing teeth, tongue and mucous membranes are cleaned with 0.5% hydrogen peroxide. Should be performed twice daily, more often if necessary.
Lubrication of mucosa	Glycerol 17% (glycerol 85%: 10 mL in 40 mL water) or moisturizers according to the patient’s preference	Apply lubricating agent on mucosa, gingiva, and tongue.
Hygiene measures, after oral care procedures	Clean water instrument washer	Toothbrushes are rinsed under running water after use, air dried standing and stored dry and clean. Remove disposable equipment immediately after use. Reusable equipment is cleaned in tap water, disinfected in washing machine between each patient. Store dry.
Documentation	Patient journal assessment form	Relevant information concerning the patient’s oral health must be registered in the patient’s medical record to provide proper health care.