This is a common symptom causing significant morbidity and distress.
It is a side effect of commonly used drugs (antidepressants, anticholinergics, morphine etc.) and radiotherapy to the head and neck.
Oral candida must be excluded and if present treated with nystatin oral suspension, Mycostatin™ pastilles or miconazole gel. Parenteral antifungals, e.g., fluconazole, may be necessary for severe cases or when oesophageal candida is suspected.
Attention to mouth cares and moistening is very important especially in the terminal phase when oral intake is reduced – this includes ice to suck, sips of water and swabs moistened with water applied to mouth and lips.
Lemon and Glycerine swabs should NOT be used as the acidity causes mouth problems after short periods of use. USE jumbo swabs moistened with fluids as desired by patient.
Sodabic mouthwashes QID are often effective (1 tsp sodium bicarbonate powder dissolved in water) or sodabic impregnated mouth swabs.
Diluted Difflam™ mouthwashes to assist with oral hygiene.
Hydrogen Peroxide is occasionally necessary for a severely coated tongue.
Saliva Substitutes are available but are of limited value.