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Mouth Care at the End of Life: A Guide for Families and Carers

When someone is very ill or dying, a dry or sore mouth is common. Keeping it clean and moist is a simple, gentle way to help them feel comfortable. Here is what palliative care guidance suggests, and where the sources differ.

Updated September 2026·By the OHA editorial team·8 min read·How we write
Key takeaways
  • A dry mouth is common near the end of life, from breathing through the mouth, drinking less and some medicines. Keeping the mouth clean and moist helps comfort and dignity.
  • Eating and drinking less is a normal part of dying, and many people no longer feel thirsty. Do not pressure them to drink.
  • If they can swallow, offer small sips. If they cannot, moisten the mouth with a little water from a spray, dropper or soft toothbrush, and keep the lips moist.
  • UK guidance advises against foam sponge swabs (the heads can come off) and lemon and glycerine swabs (they can make the mouth drier). Some other sources still mention swabs, so ask the care team what they use.
  • You do not have to do mouth care if you do not feel able to. If you would like to, the nurses can show you how.

When someone is in the last weeks or days of life, their mouth can become dry, coated or sore. The Scottish Palliative Care Guidelines (NHS Scotland) call mouth care an essential part of care in all settings. NICE guidance for England says a dying person should be offered frequent care of the mouth and lips, and family and friends encouraged to help if they wish, with advice from staff.

This guide is for families and carers; always follow the person's own care team. For everyday help, see caring for someone else's teeth.

Why does mouth comfort matter?

NHS Scotland says good mouth care helps a person's self-esteem, comfort, and ability to talk, socialise and enjoy food and drink. A West Suffolk NHS Foundation Trust palliative care leaflet adds that it can improve a dry mouth and relieve thirst.

Mouth problems are common. Marie Curie says a dry mouth affects almost 84 in 100 people being treated for advanced cancer, and that in the last days many people breathe more through their mouth and drink less. NHS Scotland lists some medicines, including strong painkillers (opioids) and water tablets (diuretics), as causes. See dry mouth.

Eating and drinking less

Marie Curie says many people stop wanting to drink, or find it hard to swallow, in their last days, and that this is normal and they should not be pressured to drink. Kent Community Health NHS Foundation Trust says most people at the end of life no longer feel hungry or thirsty. Palliative Care Australia says a fall in appetite and thirst is natural and not painful, and that trying to feed someone who cannot swallow may distress them and cause harm.

If you are worried about fluids through a drip or tube, talk to the care team. NICE says it is uncertain whether this prolongs life in the last days, and that it may ease some symptoms but cause other problems.

Kent Community Health suggests offering drinks only when the person is awake and sitting as upright as they comfortably can, with the head forwards. If they cough a lot or choke, stop and concentrate on mouth care instead. Small "tastes for pleasure" of a favourite drink or food may still be enjoyed.

Keeping the mouth moist

Suggestions from NHS Scotland, NHS inform, Marie Curie and the US National Institute on Aging (NIA) include:

  • small sips of water or cold, unsweetened drinks, if they can swallow
  • ice chips or ice lollies, only if they are awake
  • moistening the mouth with water from a spray or dropper, or a syringe without a needle (Marie Curie). NHS Scotland suggests doing this often if the person is unconscious, and not spraying at the back of the throat
  • a mouth gel or saliva spray, which a doctor, nurse or pharmacist can advise on. NHS Scotland says there is no strong evidence these work, but many people find them helpful.

Lips

Keep the lips moist to stop them cracking. The sources differ on what to use:

  • NHS Scotland advises a water-based product and says petroleum-based lip balms should be avoided, because of a fire risk and the risk of breathing them in.
  • Marie Curie suggests petroleum jelly for the lips, but not if the person is having oxygen, when it can cause blistering and is a fire hazard; then use a water-based gel.
  • The NIA suggests lip balm.

NHS Scotland and Marie Curie agree that a petroleum-based product should not be used for someone having oxygen. Ask the care team which product to use.

Sponge swabs: the sources disagree

Foam sponges on a stick are sometimes used to moisten or clean the mouth (Marie Curie). In 2012 the UK medicines regulator (MHRA) warned that the foam heads can come off during use and cause choking. NHS Scotland's guidelines say they should not be used, NHS inform says they are not safe, and Marie Curie says they are banned in Wales. The Royal College of Nursing recommends against them, and says lemon and glycerine swabs are not recommended because they can make a dry mouth worse. It suggests a soft toothbrush instead.

Other sources still describe swabs: Palliative Care Australia mentions a moist mouth swab, the NIA a specially treated swab, and a University Hospitals Birmingham leaflet foam sponges for tastes of a favourite drink. If a sponge is used, the MHRA advises checking the head is firmly attached, moistening it just before use rather than soaking it, throwing it away afterwards, and using a soft, small toothbrush instead if the person may bite down.

Cleaning teeth and dentures gently

NHS inform suggests helping with mouth care at least four times a day if you can, using a small, soft toothbrush. NHS Scotland says it works best with the person semi-upright, to avoid choking.

  • Toothpaste. Marie Curie says the mint flavour and foam of many toothpastes can be uncomfortable near the end of life, and a mild, non-foaming toothpaste may be better. If toothpaste is too uncomfortable, teeth can be cleaned with water alone.
  • If they are drowsy or unconscious, the West Suffolk leaflet suggests a smear of non-foaming toothpaste on a dry brush, or a brush dipped in water and shaken. Tell them what you are doing, and gently brush the teeth, gums, tongue, roof of the mouth and inside of the cheeks, without putting the brush too far back. If they clamp down on the brush, do not pull; wait for the jaw to relax.

Dentures

NHS Scotland says dentures can be left out at night or for long periods if that is more comfortable, especially if the mouth is sore, after discussing it with the person and family. If they are worn, clean them daily, and mark them with the person's name. The sources differ on overnight storage (NHS Scotland suggests soaking, the West Suffolk leaflet storing them dry), so ask the care team or dentist. See dentures.

Thrush, a sore mouth and other problems

Marie Curie says to tell a health professional about pain, redness, swelling, ulcers, bleeding or white patches, which can be a sign of thrush. NHS inform says thrush can look like white patches, a white coating, or a red, sore mouth, and a doctor or nurse can prescribe treatment. NHS Scotland says dentures need thorough cleaning, and toothbrushes replacing, if there is thrush. See oral thrush.

For a sore mouth, Marie Curie suggests asking about mouthwashes, painkillers or a numbing spray before meals, and cool, soft foods rather than acidic or spicy ones. For mouth problems during cancer treatment, see cancer treatment and your mouth.

Asking the care team

The West Suffolk leaflet says it is fine not to help with mouth care if you are not comfortable doing it. Marie Curie suggests asking whether a nurse can be with you the first time, and says a dentist may be able to visit at home. For someone with dementia, see dementia and oral health.

  • UK: Marie Curie Support Line, 0800 090 2309.
  • Australia: healthdirect helpline, 1800 022 222, where a registered nurse is available 24 hours a day.
  • US: the NIA lists CaringInfo, from the National Hospice and Palliative Care Organization, on 800-658-8898.
When to ask the care team
  • The mouth looks red, swollen or bleeding, or you see ulcers or white patches (Marie Curie).
  • The person seems uncomfortable with a dry mouth despite sips and moistening (Marie Curie).
  • They seem to be in pain when eating, drinking or having mouth care.
  • They cough or choke when drinking (Kent Community Health).
  • Their dentures are loose, rubbing or no longer comfortable.
  • You are unsure what to use on their lips, especially if they are on oxygen.

Frequently asked questions

Are they thirsty if they have stopped drinking?

Often not. Kent Community Health says most people at the end of life no longer feel hungry or thirsty, and Palliative Care Australia says a fall in thirst is natural and not painful. A dry mouth can still be uncomfortable, so keep it moist.

Can I still give them a taste of their favourite drink?

Often yes, if the care team agrees. NICE says a dying person should be supported to drink if they wish and are able to, after checking for swallowing problems. Kent Community Health describes small tastes for pleasure.

Should they keep wearing their dentures?

Only if it is comfortable. NHS Scotland says dentures can be left out for long periods to improve comfort, after discussing it with the person and family.

Sources

  1. Mouth care (last days of life), Scottish Palliative Care Guidelines, NHS Scotland, accessed September 2026
  2. Mouth care (palliative and end of life care: care homes and care at home), NHS Scotland Right Decisions, accessed September 2026
  3. Mouth problems in palliative care, NHS inform (Scotland), accessed September 2026
  4. Care of dying adults in the last days of life (NG31): recommendations, NICE, accessed September 2026
  5. Oral swabs with a foam head: heads may detach during use, Medicines and Healthcare products Regulatory Agency, accessed September 2026
  6. Oral hygiene in last days of life: a practical guide to performing mouth care (leaflet), West Suffolk NHS Foundation Trust, accessed September 2026
  7. Eating, drinking and swallowing at the end of life, Kent Community Health NHS Foundation Trust, accessed September 2026
  8. Information for care givers: eating, drinking and mouth care at the end of life (leaflet), University Hospitals Birmingham NHS Foundation Trust, accessed September 2026
  9. Helping someone with mouth care (oral hygiene), Marie Curie, accessed September 2026
  10. What to expect in the last days and hours of life, Marie Curie, accessed September 2026
  11. Mouth care at the end of life (for professionals), Marie Curie, accessed September 2026
  12. Mouth care during end of life care (resource for patients, family and carers), Royal College of Nursing, accessed September 2026 (marked "under review")
  13. The dying process: information for carers, Palliative Care Australia, accessed September 2026
  14. Palliative care, healthdirect Australia, accessed September 2026
  15. Providing care and comfort at the end of life, NIH National Institute on Aging, accessed September 2026

This article is general information about oral health. It is not a diagnosis or a substitute for advice from a dentist or doctor who knows your situation. If you have pain, swelling, bleeding that does not settle, or a problem that is getting worse, see a dental professional. In an emergency, contact your local emergency service.

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