Oral mucositis

An acute inflammation of the oral mucosa following systemic chemotherapy and/or radiation. Diagnosis is typically based on clinical history and physical examination.

Clinical presentation varies from erythema to patchy or confluent ulceration (often with a superficial pseudomembranous membrane) or, rarely, overt necrosis.

If severe, may warrant an undesirable chemotherapy dose-reduction and/or a break in radiotherapy.

Lesions are often very painful. Treatment is symptomatic and includes oral hygiene and pain control.

Preventive treatments include palifermin, low-level laser therapy, and use of ice-chips during chemotherapy infusion therapy.

Oral mucositis secondary to cancer therapy is an acute inflammation of the oral mucosa in response to systemic chemotherapy and/or radiation to fields involving the oral cavity. The clinical presentation ranges from a general erythematous stomatitis to erosive lesions and overt ulceration. Lesions are often very painful, may compromise nutrition and oral hygiene, and can increase the risk of local and systemic infection. Furthermore, severe oral mucositis may necessitate an undesirable chemotherapy dose-reduction and/or a break in radiotherapy. Therefore, mucositis is a highly significant complication of cancer therapy, with a potential impact on patient prognosis.[1]Lalla RV, Saunders DP, Peterson DE. Chemotherapy or radiation-induced oral mucositis. Dent Clin North Am. 2014;58:341-349. http://www.ncbi.nlm.nih.gov/pubmed/24655526?tool=bestpractice.com [Figure caption and citation for the preceding image starts]: Mucositis: dorsolateral tongueFrom the teaching collection of Rajesh V. Lalla, DDS, PhD, CCRP, DABOM; used with permission [Citation ends].[Figure caption and citation for the preceding image starts]: Mucositis: 'buccal' mucosaFrom the teaching collection of Rajesh V. Lalla, DDS, PhD, CCRP, DABOM; used with permission [Citation ends].