Mouth care and skin care in palliative medicine

doi:10.1136/bmj.317.7164.1013

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Claud Regnard, Consultant in palliative medicine,
Sarah Allport, Clinical nurse manager,
Lydia Stephenson, Senior physiotherapist

St Oswald's Hospice, Newcastle upon Tyne NE3 1EE

EDITOR—We advocated a pragmatic approach to mouth and skin care in the ABC of Palliative Care.1 Not all the suggestions in the subsequent correspondence followed the same principle.2

Lucas and Roberts rightly point to the evidence for chlorhexidine in reducing oral bacteria. They fail to point out that chlorhexidine alters taste and can damage oral mucosa and that some randomised trials have shown it to be no better than water in preventing mucositis caused by treatments …