Oral Health in Palliative Care: A Survey Study

Overview

Oral health problems such as xerostomia or oral infections are common in palliative care patients and can significantly impair quality of life. Adequate dental care may contribute substantially to symptom control and well-being; however, oral health and dental services are often insufficiently integrated into palliative care practice. In addition, little is known about the level of awareness, knowledge, and interprofessional collaboration regarding oral health among palliative care professionals. This prospective, non-interventional survey study aims to assess the relevance of oral health in palliative care by surveying both palliative care patients and healthcare professionals who are members of the German Society for Palliative Medicine. The study investigates patients' oral health status, oral health-related quality of life, and access to dental care, as well as professionals' knowledge, attitudes, and current practices related to oral health and dental care in palliative settings. The findings are intended to identify existing gaps and inform strategies for improved integration of dental expertise into palliative care.

Oral complaints are highly prevalent among patients receiving palliative care and are frequently caused or exacerbated by systemic diseases, cancer therapies, and medication-related side effects. Conditions such as xerostomia, oral candidiasis, mucositis, and pain can substantially affect nutrition, communication, comfort, and overall quality of life. Despite this high burden, oral health and dental care are often not systematically addressed in palliative care, and dental professionals are rarely integrated into interdisciplinary care structures. To date, there is limited evidence regarding how oral health is perceived by palliative care patients, how dental care is organized and accessed in palliative settings, and how well palliative care professionals are informed about common oral health problems and their management. Furthermore, barriers and facilitators of interprofessional collaboration between palliative care teams and dental professionals remain insufficiently explored. This prospective, non-interventional survey study aims to evaluate the role of oral health in palliative care from both patient and professional perspectives. Members of the German Society for Palliative Medicine (DGP) will be invited to participate in an anonymous online survey distributed via email and newsletter, with reminders sent after six and twelve weeks. The questionnaire for healthcare professionals assesses the relevance of oral health and dental care in daily clinical practice, knowledge of common oral conditions such as xerostomia and candidiasis, use of information sources and continuing education, and the integration of oral health topics into professional training and education. Palliative care patients will be recruited through direct personal approach and will complete a pseudonymized paper-based questionnaire. Patient-reported outcomes include current oral health status, presence of oral complaints, access to dental care, and oral health-related quality of life measured using the German version of the Oral Health Impact Profile 14. As this is a survey-based study, no clinical examinations or interventions are performed. Participation consists solely of completing the questionnaire once and is not part of routine clinical care. Eligible participants include adult, consent-capable palliative care patients whose health status allows questionnaire completion, as well as consent-capable DGP members. Individuals under 18 years of age or unable or unwilling to provide informed consent are excluded. Data collection is conducted at the University Medical Center Göttingen. The results are expected to provide insights into current deficits, educational needs, and structural challenges and to support the development of strategies for better integration of oral health and dental care into palliative care services.