Strategies for Oral Health Management in Patients with Acute Confusional State

Background : The presence of serious illnesses, medical complication, or drug intoxication may be the pathophysiological causes of acute confusional states (ACS). The oral diseases are highly prevalent in patients with this condition, which may cause life-threatening complications. Objectives: To describe the strategies for oral health management in patients with ACS who were treated in the inpatient ward of the Cipto Mangunkusumo Hospital. Case Report and Management: This report presented two patients with the diagnosis of ACS with differential diagnosis of dementia. The first patient was 67-year-old female with a history of nausea and vomiting before admission, eating difficulty, systemic disease and drugs use were unremarkable. The second patient was a 60-year-old female with history of nausea and vomiting every food or drinking intake, diabetes mellitus and hypertension. Clinical intraoral examination of both patients revealed poor oral health and progressive oral functional loss; However, in-office and invasive dental treatment was not indicated. The treatment focus was to improve oral comfort, oral pain management, and infection control. Conclusion : An appropriate oral healthcare plan should be considered depending on the patient’s dying stage or general condition with the collaboration between related healthcare providers.