Oral Care
Nurses play a key role in providing oral care education for patients. The
latest clinical practice guidelines for preventing and treating oral mucositis
(OM) recognize the importance of excellent oral care before and during cancer
treatment. Diligent oral hygiene and treatment of pre-existing oral or dental
conditions prior to cancer therapy may help reduce the risk and severity of
OM.1,2
Good oral hygiene prior to cancer therapy may help reduce the frequency and
severity of OM, as well as the risk of bacteremia.1,2 However,
no specific protocols of oral hygiene have been identified or proven by research.3 Nonetheless, any strategy of oral hygiene that removes debris from
the mouth, minimizes irritation, protects the gums and other mouth tissues,
reduces plaque, and provides antimicrobial prophylaxis is appropriate.1,3
Basic oral hygiene includes frequent tooth brushing, flossing, and rinsing
the mouth often with bland, nonirritating rinses including saline, sodium bicarbonate
solutions or both. Patients with dentures or other dental devices should remove
them often and soak them for 30 minutes at least once daily in an antimicrobial
solution.2,4
In addition to diligent oral hygiene prior to cancer treatment, patients
should see a dentist for a thorough assessment of the teeth and oral cavity.
Pre-existing dental or oral diseases increase the risk of septic complications.
Also, teeth or oral devices that are not in good condition can injure the oral
tissues, increasing the risk of OM.4 Therefore, to limit the risk and
severity of OM in cancer patients, oral care specialists should do the following:
- Treat periodontal conditions such as gingivitis, periodontitis and endodontic
infections.
- Repair sharp or broken teeth.
- Repair or replace poorly fitting or broken dentures.
- Remove or modify orthodontic devices.4
Protective efforts, especially diligent oral hygiene, should continue throughout
treatment and until OM has healed completely.4
Read about Other Protective Measures, such as avoiding certain foods
and products,in this section.
References
- Epstein JB, Schubert MM. Managing pain in mucositis. Semin Oncol
Nurs 2004;
20:30-7.
- Epstein JB, Schubert MM. Oropharyngeal mucositis in cancer therapy.
Review of pathogenesis, diagnosis, and management. Oncology (Huntingt) 2003;
17:1767-79.
- Rubenstein, EB, et al., Clinical practice guidelines for the prevention
and treatment of cancer therapy-induced oral and gastrointestinal mucositis. Cancer 2004;
100(9 Suppl):2026-46.
- Schubert M. Oral Mucositis in Cancer Patients. Oncology Special Edition 2004;
7:51-5.
