Letters

Mouth care and skin care in palliative medicine

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7139.1246b (Published 18 April 1998) Cite this as: BMJ 1998;316:1246

Chlorhexidine mouth washes are important in mouth care

  1. Victoria S Lucas, Clinical research fellow, department of microbiology,
  2. Graham J Roberts, Professor of paediatric dentistry
  1. Eastman Dental Institute, University of London, London WC1X 0LD
  2. Western General Hospital, Edinburgh EH4 2XU
  3. Turner Dental School, University Dental Hospital of Manchester, Manchester M15 6FH
  4. King's Healthcare NHS Trust, London SE8 9RS

    EDITOR—Regnard et al did not mention the use of 2% chlorhexidine mouth rinses in the section on mouth care and the risk factors for oral problems in their article in the ABC of Palliative Care.1 We have regular contact with groups of children with chronic disorders— for example, epidermolysis bullosa—and others who are treated with high dose chemotherapy and irradiation. One of the problems from which they suffer is severely blistered oral mucosa (children with epidermolysis bullosa) and mucositis related to chemotherapy or radiation.

    The most widely investigated and used mouth care regimen is 2% chlorhexidine mouth rinse daily. Many workers have reported decreases in dental bacterial plaque and gingivitis. This leads to decreased oral bacterial loading, which is important, particularly in patients who are undergoing a period of immunosuppression as part of their treatment.4 Chlorhexidine does not greatly affect the progress of mucositis, and although the 7% ethanol base does cause a burning sensation, the antibacterial and local cleaning action are of great benefit to these patients. Although tooth brushing is the ideal oral hygiene method, most patients who are debilitated are unable to …

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