Palliative care needs to be integrated into dentistry, says M.R. Rajagopal

Head and neck cancer survivors go through significant physical and psychological trauma post-treatment because of aesthetic impairments as well as functional deficits. These patients who have gone through surgery, chemo and radiation therapy, end up with oral complications such as mucositis (inflammation of the mucous membrane inside the mouth), xerostomia (dry mouth leading to difficulty in eating, bad breath and increased risk of tooth decay) and dental infections. This also affects their intake of food, nutrition and overall health, significantly reducing the quality of life.

“More often than not, the dental health issues faced by these patients are neglected or never addressed properly when the focus is more on the physical issues of the patients and keeping them cancer-free. But their suffering is real and it affects their psychological well-being. It is high time routine dental care was made part of general healthcare and palliative care integrated into dentistry so that the oral health issues faced by these patients are appropriately and empathetically managed,” says M.R. Rajagopal, Chairman Emeritus, Pallium India.

Pallium India has started a new Department of Palliative Care Dentistry at its headquarters in the capital, in an effort to address the oral health issues faced by cancer patients as well as those with chronic conditions and are on palliative care.

Significant burden

Oral and maxillofacial cancers impose a significant burden in Kerala, with the incidence rates around 17.7 per 100,000 for rural men and 9.3 per 100,000 for rural women. Cancer of the oral cavity comprises about 5-7% of cancers in men in recent population-based registries from Kerala. A 2025 Kerala Cancer Conclave study notes that oral cavity cancer accounts for 10% of cancers in men statewide, with Kerala contributing 5.7% to India’s total cancer burden amid rising overall cases.

“Many patients with chronic health conditions or the elderly also frequently experience dental health issues. Attending to these oral health issues in a timely manner with care and compassion relieves them of their suffering and improves their quality of life,” points out Dr. Rajagopal.

“Palliative care is now included in the MBBS and Nursing curriculum in Kerala, so young medical students get an insight into this aspect of medical care early. However, inclusion of palliative care in the dental medicine curriculum (in Kerala) is something that the Indian Dental Council is yet to approve. It is important that the dental professionals are trained in palliative care so that they also learn to be more empathetic and compassionate to their patients,” says Amirtha Thampi, who is in charge of the Palliative Dentistry at Pallium India.

There are numerous studies highlighting the critical role of integrating palliative care into dental medicine, where dentists address pain, infections, and functional issues to enhance quality of life. In Western countries, this integration is advancing through interdisciplinary models.

Dentists contribute by providing symptom relief via extractions, palliative restorations, and oral hygiene protocols, fostering multidisciplinary care that aligns with WHO palliative principles.

Key milestone

Pallium India considers its Palliative Dentistry department as an important milestone in integrating palliative care practice into oral health, ensuring compassionate, appropriate, and person-centred care for those living with serious illness. Dr. Rajagopal would like to introduce a mobile dental unit too, over time.

“This is new learning for us too and we are taking things one step at a time,” says Dr. Thampi.