The dentist's role in end-of-life care.

Dentists and dental specialists have much to offer in ensuring proper pain management in end-of-life care for terminally ill patients. As the population of the United States ages and devastating disease processes continue to affect many, the need for oral comfort care measures will further increase. In an ideal situation, the dentist will be among those consulted in advance of beginning therapeutic regimens that have significant oral side-effects or for cases in which oral care after treatment has begun is accompanied by greatly increased risk. The objectives for dentists caring for terminally ill patients include ensuring comfort, eliminating sites of infection or potential infection, understanding the patient's preferences enhancing oral function, and, when desired, protecting self-esteem through esthetic maintenance. The provision of adequate pain management and comfort care is an unequivocal ethical obligation for the benefit of these patients. Dentists have a further ethical obligation to share their knowledge with physicians and patients to set a higher standard for comfort care for the terminally ill.