Oral Mucositis Overview

Oral Mucositis

• Mucositis refers to inflammation of the mucosa, resulting in mouth sores and esophagitis.
• Symptoms can range from redness and soreness to open sores, impacting the ability to eat.
• Chemotherapy and radiation therapy can damage healthy cells, specifically those in the gastrointestinal (GI) tract, leading to mucositis.
• Consequences of mucositis include:
  • Pain and discomfort
  • Nutritional deficiencies due to reduced food intake
  • Increased risk of infections from open sores
  • May limit chemotherapy dosage due to severity
• Signs and symptoms of mucositis include:
  • Red, shiny, or swollen gums and mouth
  • Presence of blood in the mouth
  • Sores on gums or tongue
  • Pain or soreness in the mouth/throat
  • Difficulty swallowing or speaking
  • Dry mouth or burning sensations while eating
  • Soft whitish patches or pus in the mouth
  • Thicker saliva or increased mucus production
• Importance of reporting symptoms to a healthcare provider for prompt attention
• Effective oral care strategies to manage and prevent mucositis severity:
  • Rinse mouth pre- and post-meal and bedtime with saline or a salt and soda solution
  • Use a soft-bristle toothbrush or toothettes if pain occurs
  • Apply non-abrasive toothpaste; avoid whiteners
  • Keep lips moisturized
  • Avoid irritating products such as alcohol-containing mouthwashes, excessive dental floss, and citrus-based swabs
  • Increase fluid intake and consume protein-rich foods
  • Avoid hot, spicy, acidic, hard, or coarse foods
• Denture care guidelines:
  • Remove dentures when not eating to expose gums to air
  • Avoid loose-fitting dentures that may cause irritation
  • Refrain from wearing dentures if sores are severe
  • Discourage smoking and chewing tobacco

Hair Loss

• Chemotherapy drugs effectively target cancer cells but also harm rapidly dividing normal cells, including hair follicles.
• Hair loss typically begins between 7 to 21 days after starting chemotherapy.
• Factors influencing hair loss extent include:
  • Type and dose of chemotherapy drug
  • Combination of drugs used in treatment
  • Administration route (e.g., IV, oral)
  • Duration of chemotherapy
• Not all chemotherapy drugs induce hair loss; drugs with higher likelihood include:
  • Cyclophosphamide, Dactinomycin, Daunorubicin, Docetaxel, Doxorubicin, Eribulin, Etoposide, Idarubicin, Ifosfamide, Irinotecan, Paclitaxel, Topotecan
• Tips for managing hair loss:
  • Maintain a clean, moisturized scalp to prevent skin breaks
  • Use baby shampoo or mild products for hair care
  • Consider satin or silk pillowcases to reduce friction
  • Choose a wig preemptively, which is often covered by insurance
  • Accessories like hats, caps, scarves, or turbans for coverage
  • Apply sunscreen on the scalp when outdoors
• Hair loss is usually temporary, with regrowth occurring post-treatment, potentially in a different color or texture.