Oral Mucositis
Refers to erythematous &ulcerative lesions of oral mucosa observed in the patients with cancer being treated with Chemotherapy and radiotherapy
Lesions are often very painful &compromise nutrition &oral hygiene &as well as increase risk for local&systemic infections
It also involve other areas of the alimentary tract for eg—GIT mucositis can manifest as diarrhea
Oral mucositis initially presents as a erythema of the oral mucosa which then often progresses to erosion and ulceration. The ulcerations are typically covered by a white fibrinous pseudomembrane. The lesions heal within approximately 4-6 weeks after the last dose of somatotoxic chemotherapy or radiation therapy
Several factors affect the clinical course of mucositis Lesions are usually limits to non-keratinized surfaces ie lateral and ventral tongue,, buccal mucosa &soft palate .Ulcers arise within 2 wks after initiation of therapy The cinical severity is directly proportional to the dose of radiation administered .Most patients who have received more than 5000cGy to the oral mucosa will devlop severe ulcerative oral mucositis
Clinical course of oral mucositis may sometimes be complicated by local infections such as Herpes - simplex and fungal infections such as candidiasis
Management of oral mucositis has been largly palliative
Primary symptom pain affects nutritional intake ,,mouth care &quality of life.. Thus pain management is of upmost imp in this case .. saline gargles ,,ice chips,,&topical mouth rinse contaning lidocaine an anesthetic agent can be used
Nutritional intake can be severly compromised by pain& in addition taste change also occur after chemo,, radiotherapy,, It is essential to monitor nutritional intake &weight .A soft diet ,, liquid diet when oral mucositis present
TREATMENT OF DRY MOUTH---Patients undergoing cancer therapy suffer from xerostomia (Dry mouth) or hyposalivation can further aggrevate inflamed tissues &increase local infection &make mastication difficult &aggrevate the oral mucositis . hence treatment for such conditions should also be considered
A--- chewing of sugarless gum to stimulate flow
B ---use of cholinergic agents as necessary
C ----adv to sip water frequently allieviate dry—
TREATMENT OF BLEEDING---In the patients who are thrombocytopenic as a result of high dose chemotherapy ,, bleeding may occur from ulcerative oral mucositis This can usually be controlled by local hemostatic agents such as fibrin,,glue or gelatin spongue
Oral mucositis is a clinically imp &sometimes dose limiting complication of cancer therapy
Clinical management is largly focused on palliative measure such as pain management ,, nutritional support& maintanaince of good oral hygiene