Aroma-oral care study in palliative care (part 1)


Objectives: An aroma-oral care study was conducted to explore the effects of aromatic water that was added to regular oral hygiene care in palliative patients.

Design: Aromatic water mixture (AWM) added to regular oral hygiene care in palliative patients at five different facilities. Each staff member using the protocol filled out a questionnaire wrote case studies and a review of the results.
Methods: AWM was added to regular oral hygiene care by replacing the regular solution used in mechanical oral care or as an addition to regular oral care as a daily spray. The original AWM consisted of equal parts (1/3) Satureja montana (winter savory), Laurus nobilis (laurel leaf) and Salvia officinalis (sage). In 11 cases, participants chose to use a different hydrolat or hydrolat mixture instead.

Results: 24 palliative care patients participated in this study. 75 % of patients had better breath and reported the oral mucosa was more hydrated, 70% of patients had less lining the mouth and better tongue colour. There were 0% contraindications and 100% reported satisfaction from the staff using the hydrolats.

Conclusion: The study results showed that incorporating hydrolats in oral hygiene can help refresh oral mucous membrane, improve breath, taste and other aspects of oral care. This gentle and affordable addition to regular oral care has no negative side effects and provides a broad spectrum of potential benefits that should be further explored.



Oral hygiene is an important aspect of a healthy life. With appropriate oral hygiene, we can significantly influence the quality of life. With ageing, our body is subjected to social, psychical and physical changes. Due to alterations in lifeblood, the oral cavity is adapting which may consequently result in disorders in metabolism and nutrition. Beside sclerosed changes in connective tissue, atrophy of epithelium and bones are quite frequent. (Rode, 2008). Physiologically, reduction of saliva’s secretion is a huge risk factor for the development of medical conditions in the oral cavity such as dry mouth, mouth ulcers, fungal infections (such as Candida Albicans), linings, periodontal disease, etc. The affected oral mucosa creates an environment suitable for developing various infections. It is related to sleep disturbances, poor nutrition, and even communicational and cognitive degeneration. The primary goal of the research was to assess beneficial effects of hydrolats and their blends in addressing above mentioned symptoms by providing palliative patients with AWM solution along part with their regular oral hygiene procedures two to 5 times a day.

Research methods used in the aroma-oral care study

The main goal of the aroma-oral care study was to increase the effectiveness of oral hygiene by introducing aromatic water. Some of the specific other study goals included addressing symptoms such as dry mouth, foul breath, soreness and inflammation in the mouth, as well as to stimulate appetite.

The study was conducted at five different facilities listed below.

  • Home for elderly care DEOS, Center starejsih Crnuce represented by Petra Jenko, Occupational Therapist
  • Home for elderly care DEOS, Center starejsih Zimzelen Topolica represented by Andreja Stefan Bukovic, Director of the Care Center of Elderly and Ana Simenc, Working Instructor
  • Home for elderly care Dom Petra Uzarja, represented by Maja Krzisnik, Registered Nurse
  • Home for elderly care Logatec represented by Mojca Tuljak, Occupational therapist
  • General Hospital Jesenice, Center for interdisciplinary pain treatment and palliative care, Mobile palliative team represented by Darja Noc, Registered Nurse

All listed facilities used added aromatic water mixture (AWM), described below, to their daily oral care routine to 3 to 6 of their patients. 11 AWMs were modified during the study to meet patients’ specific requirements.

The aromatic water mixture of Satureja montana (winter savory), Laurus nobilis (laurel leaf) and Salvia officinalis (sage) in equal parts was provided to palliative patients 2 to 5 times a day for a minimum period of 3 days, maximum of 145 days and an average of 48 days. An overview of the time period is presented in the chart below.

The hydrolats were selected for their properties as well as because they are herbs commonly used and familiar to this area. Taste and smell of the mixture may remind patients of familiar food, home and comfort. Additional motivation for selecting locally produced hydrolats is to support local distillers and to use hydrolats that are as fresh as possible. Local distillers donated hydrolats used in the study. More details about the selected hydrolats and the reasoning behind the selection are presented in Table 1.

Winter savory hydrolat was selected for its antibacterial, antifungal, antiseptic (Catty 2001, p. 132), revitalising and energising (Viaud 1983; Grosejean 193b, p. 56) properties. Laurus nobilis was chosen for its analgesic, anti-infectious (Franchomme et Penoel 1990; p. 281), anti-inflammatory (Baudox 1996b, p. 96), antiseptic, antibacterial, antiviral (Harman 2015, p. 185), carminative (Viaud 1983), digestive (Rose 1999, p. 172) properties and Salvia officinalis for its analgesic, antifungal, antimicrobial, carminative (Harman 2015, p. 182), anti-infectious, anti-inflammatory (Price and Price 2004, p. 139), antiseptic (Baudox 1996a), cicatrizant (Baudox 1996a), digestive (Grosjean 1993b, p.55) properties. The hydrolats were wild grown.

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Melani Kovač
aromatherapist, educator

Andreja Stefan Bukovic, Ana Simenc, Darja Noc, Maja Krzisnik, Mojca Tuljak and Petra Jenko for their research and cooperation with this study. Stjepko Curin (PTO Curin), Jana Bergant (Histria Botanica) for donating hydrolats and Petra Sedej (Aromazen) for donating spray bottles. Maja Pecenic for her advice in the writing of this article.

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