Patients may experience mucositis during various forms of cancer therapy, including chemotherapy, radiation therapy, and bone marrow transplant. Incidence is estimated at 40% for those undergoing chemotherapy, 75% of those having bone marrow transplant and high dose chemotherapy, and 30-60% of those undergoing radiation therapy.

 

Pathophysiology

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The routine turnover of cells is impaired, resulting in cell death without replacement. Ulceration can result, and bacteria may invade due to lack of protection, resulting in inflammation.

 

Impact

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It is important to address mucositis so that patients can be comfortable. Discomfort can result in oral health choices which can cause long term harm, such as soft, carbohydrate-rich foods which increase risk of tooth decay. Unaddressed pain may lead to a desire to abandon treatment. It is therefore critical to prevent or manage if it occurs.

 

Timing

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Typically mucositis is seen 7-10 days after start, and typically ceases 2-4 weeks after.

 

Prevention

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• Diet

• Good plaque control

• No smoking

• Advise to see dentist for silicone blocks to cover metallic dental restorations

 

Management

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A variety of agents are available and have different levels of efficacy.

 

Providers often recommend “Magic Mouthwash” however it is critical to know whether what you are prescribing contains agents, including sugars, that can be detrimental to oral health.Additional agents- Benzydamine, Cryotherapy

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​For more information about mucositis and oral health, see these resources:

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• Oral Complications of Cancer Therapies - National Cancer Institute

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You may also wish to learn about:

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• Dry Mouth (Xerostomia)

• Psychosocial Challenges​

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