Mucositis management and patient education


Perform oral assessment daily. Utilizing an oral assessment guide allows the individual and nurse to see and document oral status systematically before and through treatment. Teach the individual to complete self-assessment. Refer the individual for any dental consultation before chemotherapy starts. Teach the individual a great daily dental hygiene regimen:

Perform preventive mouth care every 4 hours while awake. If mild stomatitis occurs, do mouth care every 4 hours night and day; in severe stomatitis, every 2 hours is mandatory.

Brush one's teeth gently having a soft toothbrush or tooth-ettes after meals and also at bedtime. Use waxed dental floss since it is easier on the gums.

Stay away from commercial mouthwashes containing alcohol simply because they irritate and dry the tissues. Rinse the mouth with warm saline or with those who are rinses. Peroxide mouthwash isn't recommended since it disturbs the standard flora of the mouth and results in overgrowth of fissures and white papillae of the tongue, resulting in candidiasis. Wear dentures only when necessary.

Advise the individual to consume a high-protein diet and also to drink as much as 3 L/day, otherwise contraindicated. Avoid hot, spicy foods or foods high in sugar. Avoid oral irritants for example alcohol and tobacco.

Treat oral infection early with antifungal or antiviral agents as ordered. Agents popular are nystatin being an oral tablet, a vaginal tablet, or perhaps an oral suspension 4 times each day. Other recommended agents are clotrimazole troches, chlorhexidine, Neosporin ointment put on perioral infections, sucralfate, and allopurinol mouthwash.

Administer local or systemic pain medications as ordered. These medications can include 2% viscous lidocaine administered 30 minutes before eating, dyclonine hydrochloride in a 0.5% to 1.0% solution like a topical anesthetic, or diphenhydramine hydrochloride elixir.

Make use of a topical protective agent to advertise healing, for example kaolin-pectin preparations, having a Maalox substrate. Rinse with saline or water after twenty minutes.

When the patient has xerostomia, use saliva substitutes and sialagogues. Other measures are sucking on hard, sugarless candy, chewing sugarless gum, and keeping the lips and mouth area moist with petroleum jelly or butter.

Teach the individual to inform the nurse or physician when the temperature exceeds 38°C or if bleeding and poor pain control occur, which could compromise nutritional intake.

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This article was sent to us by: Duane Owens at 07262011

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