Oral Care

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 mucosa, 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.