{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T07:03:04Z","timestamp":1782975784635,"version":"3.54.5"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Dent. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Oral health influences comfort, communication, and quality of life in palliative care. However, its clinical drivers and prognostic significance remain poorly understood. This study examined longitudinal changes in oral conditions over time and identified factors associated with oral deterioration or improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A longitudinal observational study was conducted involving 300 inpatients receiving palliative care. Each patient underwent routine oral assessments using the Oral Health Assessment Tool (OHAT) both before and after oral care. Clinical characteristics, functional status activities of daily living (ADL), number of remaining teeth, oral care frequency, and outcomes at discharge were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At baseline, 11.3% of the participants had oral candidiasis, which was associated with poorer oral health assessment scores. Among patients who subsequently died, the prevalence of candidiasis declined significantly after care, while oral health assessment scores worsened, particularly in the \u201ctongue\u201d and \u201csaliva\u201d categories. This paradoxical pattern may suggest a rapid shift in the microbiota immediately preceding death, despite oral care. In contrast, among patients who were discharged alive, candidiasis improved in 81.3% of affected individuals, and oral health assessment scores improved significantly. Post-care oral health assessment scores were influenced by activities of daily living, sex, and the number of remaining teeth. Patients with poorer baseline oral health assessment scores tended to show the greatest improvement, while those with initially better scores often deteriorated, possibly due to reduced care frequency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In palliative care, oral health is affected by activities of daily living, remaining teeth, sex, and the presence of candidiasis. Rapid intraoral decline near the end of life, coupled with reduced candidiasis, may reflect changes in oral conditions near the end of life; however, because no microbiological analyses were performed, this interpretation remains speculative. Longitudinal evaluation of functional status and oral conditions, potentially enhanced by artificial intelligence-based image analysis, may help clarify prognostic associations rather than provide definitive prognostic accuracy, and could support more tailored oral care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fdmed.2026.1831411","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T05:34:40Z","timestamp":1782970480000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal changes in oral conditions and oral candidiasis in palliative care inpatients: a longitudinal observational study"],"prefix":"10.3389","volume":"7","author":[{"given":"Taeko","family":"Fukutani","sequence":"first","affiliation":[{"name":"Department of Dentistry and Oral Surgery, Hiroshima City North Medical Center Asa Citizens Hospital","place":["Hiroshima, Japan"]},{"name":"Department of Oral Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University","place":["Hiroshima, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arisu","family":"Shibata","sequence":"additional","affiliation":[{"name":"Department of Dentistry and Oral Surgery, JA Onomichi General Hospital","place":["Onomichi, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Okazaki","sequence":"additional","affiliation":[{"name":"Department of Dentistry and Oral Surgery, JA Onomichi General Hospital","place":["Onomichi, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chie","family":"Okugawa","sequence":"additional","affiliation":[{"name":"Department of Dentistry and Oral Surgery, JA Onomichi General Hospital","place":["Onomichi, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunki","family":"Izumi","sequence":"additional","affiliation":[{"name":"Department of Dentistry and Oral Surgery, Hiroshima City North Medical Center Asa Citizens Hospital","place":["Hiroshima, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiya","family":"Hayashi","sequence":"additional","affiliation":[{"name":"Department of Oral Surgery, Hiroshima Red Cross & Atomic-Bomb Survivors","place":["Hiroshima, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoji","family":"Nakase","sequence":"additional","affiliation":[{"name":"Department of Dentistry and Oral Surgery, Hiroshima City North Medical Center Asa Citizens Hospital","place":["Hiroshima, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasutaka","family":"Ishida","sequence":"additional","affiliation":[{"name":"Department of Oral Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University","place":["Hiroshima, Japan"]},{"name":"Department of Dentistry and Oral Surgery, JA Onomichi General Hospital","place":["Onomichi, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoaki","family":"Hamana","sequence":"additional","affiliation":[{"name":"Department of Oral Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University","place":["Hiroshima, Japan"]},{"name":"Department of Dentistry and Oral Surgery, JA Onomichi General Hospital","place":["Onomichi, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souichi","family":"Yanamoto","sequence":"additional","affiliation":[{"name":"Department of Oral Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University","place":["Hiroshima, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosei","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Dentistry and Oral Surgery, Hiroshima City North Medical Center Asa Citizens Hospital","place":["Hiroshima, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"B1","year":"2002"},{"key":"B2","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1007\/s00520-015-2734-5","article-title":"The need and availability of dental services for terminally ill cancer patients: a nationwide survey in Japan","volume":"24","author":"Ohno","year":"2016","journal-title":"Support Care Cancer"},{"key":"B3","doi-asserted-by":"publisher","first-page":"26","DOI":"10.4103\/0973-1075.53508","article-title":"Dental expression and role in palliative treatment","volume":"15","author":"Saini","year":"2009","journal-title":"Indian J Palliat Care Dent"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2980","DOI":"10.21037\/apm-22-215","article-title":"A systematic review of interventional studies on oral care of palliative patients","volume":"11","author":"Dhaliwal","year":"2022","journal-title":"Ann Palliat Med"},{"key":"B5","first-page":"453","article-title":"The treatment of oral problems in the palliative patient","volume":"72","author":"Wiseman","year":"2006","journal-title":"J Can Dent Assoc"},{"key":"B6","doi-asserted-by":"publisher","first-page":"901","DOI":"10.2512\/jspm.11.901","article-title":"Increased cooperation with dentistry by the palliative care team","volume":"11","author":"Kawabata","year":"2016","journal-title":"Palliat Care Res"},{"key":"B7","doi-asserted-by":"publisher","first-page":"237","DOI":"10.15214\/jsodom.30.237","article-title":"A clinical study on the perioperative management of oral function in palliative care units","volume":"30","author":"Kubo","year":"2017","journal-title":"Jpn J Oral Diagn Oral Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1016\/S0140-6736(19)31133-X","article-title":"Ending the neglect of global oral health: time for radical action","volume":"394","author":"Watt","year":"2019","journal-title":"Lancet"},{"key":"B9","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1186\/s12903-020-01075-w","article-title":"Oral health problems among palliative and terminally ill patients: an integrated systematic review","volume":"20","author":"Venkatasalu","year":"2020","journal-title":"BMC Oral Health"},{"key":"B10","doi-asserted-by":"publisher","first-page":"2187","DOI":"10.1016\/S0140-6736(22)00740-1","article-title":"The value of oral care in dying and death","volume":"399","author":"Lobbezoo","year":"2022","journal-title":"Lancet"},{"key":"B11","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1186\/s12903-024-04233-6","article-title":"Efficacy of episil\u00ae in patients with hematologic malignancies: a comparative study","volume":"24","author":"Fukutani","year":"2024","journal-title":"BMC Oral Health"},{"key":"B12","doi-asserted-by":"publisher","first-page":"42","DOI":"10.21037\/apm-23-456","article-title":"Changes in oral health status in terminal cancer patients during the last weeks of life","volume":"13","author":"Okamoto","year":"2024","journal-title":"Ann Palliat Med"},{"key":"B13","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1007\/s00520-025-09453-2","article-title":"Comparison of nurse-led oral health care and dental professional-led oral health management in terminally ill cancer patients receiving palliative care: a longitudinal study","volume":"33","author":"Suzuki","year":"2025","journal-title":"Support Care Cancer"},{"key":"B14","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1111\/j.1834-7819.2005.tb00360.x","article-title":"The oral health assessment tool\u2014validity and reliability","volume":"50","author":"Chalmers","year":"2005","journal-title":"Aust Dent J"},{"key":"B15","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1002\/cre2.481","article-title":"Oral health assessment tool (OHAT) deputized to informal care givers: go or no go?","volume":"8","author":"Ho","year":"2021","journal-title":"Clin Exp Dent Res"},{"key":"B16","first-page":"241","article-title":"Nutrition and diet of 80-year-old Japanese persons retaining 20 teeth per individual","volume":"46","author":"Morita","year":"1996","journal-title":"J Dent Health Tokyo"},{"key":"B17","doi-asserted-by":"publisher","first-page":"S180","DOI":"10.4103\/jpbs.JPBS_636_20","article-title":"Assessment of oral health-care needs for patients under palliative care","volume":"13","author":"Singh","year":"2021","journal-title":"J Pharm Bioallied Sci"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1026","DOI":"10.61872\/sdj-2019-12-589","article-title":"Social distance towards halitosis sufferers","volume":"129","author":"Azodo","year":"2019","journal-title":"Swiss Dent J"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1463","DOI":"10.1007\/s00520-021-06547-5","article-title":"Factors affecting the oral health of inpatients with advanced cancer in palliative care","volume":"30","author":"Furuya","year":"2022","journal-title":"Support Care Cancer"},{"key":"B20","first-page":"75","article-title":"Association between survival prognosis and intraoral conditions in cancer patients receiving palliative care","volume":"35","author":"Terada","year":"2020","journal-title":"Jpn J Gerodontol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s12904-020-00684-0","article-title":"Effects of professional oral care on oral health in terminally ill cancer patients: a prospective study","volume":"19","author":"Wu","year":"2020","journal-title":"BMC Palliat Care"},{"key":"B22","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1177\/1049909119829411","article-title":"Oral hygiene care in patients with advanced disease: an essential measure to improve oral cavity conditions and symptom management","volume":"36","author":"Magnani","year":"2019","journal-title":"Am J Hosp Palliat Care"},{"key":"B23","doi-asserted-by":"publisher","first-page":"6289","DOI":"10.1007\/s00520-021-06212-x","article-title":"Oral dryness and moisture degree at the lingual but not buccal mucosa predict prognosis in end-of-life cancer patients","volume":"29","author":"Shimosato","year":"2021","journal-title":"Support Care Cancer"},{"key":"B24","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1111\/scd.12874","article-title":"Association between poor oral health and overall mortality in palliative care patients: an analysis using time-dependent receiver operating characteristic curves","volume":"44","author":"Nakao","year":"2024","journal-title":"Spec Care Dentist"},{"key":"B25","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1007\/s12105-019-01004-6","article-title":"Candidiasis: red and white manifestations in the oral cavity","volume":"13","author":"Hellstein","year":"2019","journal-title":"Head Neck Pathol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"e0276922","DOI":"10.1128\/mbio.02769-22","article-title":"Human tooth as a fungal niche: candida albicans traits in dental plaque isolates","volume":"14","author":"Xiang","year":"2023","journal-title":"mBio"},{"key":"B27","doi-asserted-by":"publisher","first-page":"e00339","DOI":"10.1128\/IAI.00339-19","article-title":"Multi-omics analyses reveal synergistic carbohydrate metabolism in Streptococcus mutans-Candida albicans mixed-species biofilms","volume":"87","author":"Ellepola","year":"2019","journal-title":"Infect Immun"},{"key":"B28","doi-asserted-by":"publisher","first-page":"15579883211016361","DOI":"10.1177\/15579883211016361","article-title":"Men and oral health: a review of sex and gender differences","volume":"15","author":"Lipsky","year":"2021","journal-title":"Am J Mens Health"},{"key":"B29","doi-asserted-by":"publisher","first-page":"461","DOI":"10.14958\/jjsdh.40.461","article-title":"Relationship between ADL and oral health condition and nutritional status in post-acute-stage stroke patients","volume":"40","author":"Ninomiya","year":"2019","journal-title":"J Jpn Soc Disabil Oral Health"},{"key":"B30","volume-title":"Contemporary Preventive Dentistry","author":"Yonemitsu","year":"2013"},{"key":"B31","doi-asserted-by":"publisher","first-page":"146","DOI":"10.7881\/dentalmedres.32.146","article-title":"Dysfunction and restoration of salivary glands","volume":"32","author":"Mishima","year":"2012","journal-title":"Dental Med Res"}],"container-title":["Frontiers in Dental Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fdmed.2026.1831411\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T05:34:42Z","timestamp":1782970482000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fdmed.2026.1831411\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,2]]},"references-count":31,"alternative-id":["10.3389\/fdmed.2026.1831411"],"URL":"https:\/\/doi.org\/10.3389\/fdmed.2026.1831411","relation":{},"ISSN":["2673-4915"],"issn-type":[{"value":"2673-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,2]]},"article-number":"1831411"}}