Prevention of bad breath in palliative care
Bad breath usually originates in the oral cavity and is caused by bacteria that produce volatile sulfur compounds (VSCs) when they break down lingering food particles in the mouth. In healthy persons, the saliva helps get rid of food debris and control the amount of bacteria and fungus in the mouth. However, end-of-life patients often have dry mouth (xerostomia), which allows the bacteria to colonize and cause bad breath. Sipping on water frequently and using saliva substitutes can help alleviate bad breath caused by dry mouth.
Palliative care dentistry is often neglected, but good mouth care is important for the patient’s comfort, self-esteem, ability to communicate, socialize and enjoy food and drinks. Persson thinks patients should receive a thorough cleaning of the oral cavity on a daily basis. In addition to regular toothbrushing and flossing, applying a fluoridated mouthwash, such as CB12, with a swab can help prevent bad breath in very ill patients. CB12 protects against tooth decay and chemically binds the VSCs that cause bad breath using a combination of zinc acetate and chlorhexidine. "CB12 is a good product," says Persson. "I use it for my sick patients. I let them rinse once a day, in the morning, and then their breath stays fresh for several hours. If they have severe problems I let them rinse more often."