Xerostomia is common in people with advanced illness and may affect oral comfort, speech, eating, swallowing, sleep, and social interaction. Its assessment is complicated by the distinction between the subjective experience of dry mouth and objectively measurable salivary gland hypofunction. Management evidence is distributed across palliative care, oncology, oral medicine, nursing, and symptom-management literature. To map contemporary evidence on the definition, causes, assessment, clinical consequences, and management of xerostomia in palliative care, with particular attention to oral comfort and nursing practice. A scoping-review approach informed by PRISMA-ScR and contemporary methodological guidance was used. Literature from 2017–2026 was examined across xerostomia, dry mouth, hyposalivation, palliative and end-of-life care, oral assessment, cancer treatment, medication exposure, oral care, salivary stimulation, and nursing. Evidence was charted according to population, care setting, measurement approach, etiologic context, intervention or practice, professional role, reported outcomes, and applicability to palliative care. Because the web-accessible search interfaces used during review development did not provide reproducible native database hit totals, numerical retrieval and deduplication counts were not reconstructed retrospectively. The mapped literature distinguishes patient-perceived xerostomia from salivary gland hypofunction and shows substantial variation in symptom ascertainment, objective measurement, treatment context, and management strategy. Patient-reported burden is not fully captured by clinical dryness or salivary measures alone. Evidence for specific interventions in palliative populations remains sparse and heterogeneous, whereas oral care, symptom assessment, medication review, patient education, and interprofessional collaboration recur across guidance and nursing literature. Xerostomia in palliative care is best approached as a multidimensional symptom and care problem. Assessment should preserve both patient-reported and clinically observed information, while management should remain individualized, comfort-oriented, and sensitive to cause, residual salivary function, treatment burden, and patient priorities.
