Serving Clients Facing End of Life Oral Comfort Care and Hospice Noel Kelsch RDH, RDHAP, AS, BS [email protected]

Goals: 1. Identify the end-of-life patient’s oral care needs and palliative care protocols. 2. Learn the role of the dental professional in delivery of comfort care and hospice care. 3. Develop an oral treatment protocol and plan for patients facing the end of life.

Resources: http://www.noelkelsch.com/articles Hospice Hygiene Understanding Bereavement

Compounding Pharmacy Items Anesthetic Lidocaine HCl 10%/Prilocaine HCl 10%/Tetracaine HCl 4% Dental Gel Lidocaine HCl 20%/Tetracaine HCl 4%/Phenylephrine HCl 2% Dental Gel (LTP Gel) Lidocaine HCl 10%/Phenylephrine HCl 2%/Prilocaine HCl 10%/Tetracaine HCl 4% Dental Gel Tetracaine HCl 0.5% Lollipop

Angular Chelitis Clotrimazole 2%/Ibuprofen 2%/Tea Tree Oil 5% Topical Cream Miconazole 2%/Ibuprofen 1%/Tea Tree Oil 1% Topical Cream

Burning Mouth Syndrome Salicylic Acid 0.3% Mouthwash Capsaicin 0.25 mg Troche Amitriptyline HCl 2%/Gabapentin 6%/Lidocaine HCl 0.5% Oral Rinse

Dry Mouth Pilocarpine Hydrochloride 5 mg Lollipop Pilocarpine Hydrochloride 5mg Xyitol 2 mg Lollipop Pilocarpine HCl 2 mg Troche Pilocarpine 10 mg/ml Oral Spray Electrolyte Troche Saline/Glycerin Oral Suspension

Herpies Acyclovir 2%/Deoxy-D-Glucose (2) 0.2% Lip Balm Acyclovir 5%/Lidocaine 1% Lip Balm

Mucocitis/Ulcers Polyox 301 Oral Mucosal Bandage, variety of drugs may be incorporated. Negatan Tetracycline HCl 125 mg/Nystatin 60417 units/Diphenhydramine HCl 12.5 mg/ Hydrocortisone 2.3 mg Troche Tetracycline HCl 1.25%/Nystatin 12000 u/mL/Hydrocortisone 0.05%/Chlorpheniramine Maleate 0.02% Mouthwash Misoprostol 0.0024%/Diphenhydramine HCl 0.1%/Compound Oral Rinse (Radiation Burn Mouth Rinse) Morphine Sulfate 1 mg/mL Oral Gel Triamcinolone in Oral Adhesive Paste Thrush BAX: lidocaine, diphenhydramine, sorbitol/xylitol, and Mylanta

Thrush (0ral Candidia) Amphotericin 100 mg Troche Formula Alcohol Free Chlorhexidine Amphotericin B 100 mg/mL Oral Suspension Chlorhexidine 0.12% Oral Rinse Acyclovir 10% Flavored Lip Ointment