Abstract
Background
The Basic Oral Care Group is one of eight subcommittees functioning within the Mucositis Study Group Guidelines Panel of the Multinational Association of Supportive Care in Cancer and International Society for Oral Oncology (MASCC/ISOO). The Basic Oral Care Group, comprised of the four authors of this paper, represented the disciplines of nursing (DBM, JJ), dentistry (MEPC), and pediatric dentistry (PW). This group reviewed research and clinical literature to update the original 2004 Mucositis Management Guidelines in the areas of basic oral care, bland rinses, protocols and education, and good clinical practices such as pain management, oral assessment, oral care, and dental care.
Materials and methods
Over 100 articles published between 2000 and 2005 were identified, and 32 of these were useful for the analysis. Each article was rated by at least two authors using a structured rating form and systematic determination of levels of evidence, based on the American Society of Clinical Oncology criteria. Discussion at the 2005 MASCC/ISOO Geneva preconference meeting of the Guidelines Panel resulted in the development of consensus on the interpretation of the literature.
Results
Based on the literature and on Panel discussions, a revision of the original guidelines for protocols and education was produced by the group, and they developed a set of recommendations related to good clinical practices.
Conclusions
Although research remains scanty for components of basic oral care, bland rinses, protocols, and education, the original 2004 guidelines with the help of newer literature from 2000 to 2005 and expert consensus among the Guidelines Panel enabled the development of useful clinical practice guidelines for managing oral mucositis in patients receiving cancer treatment with radiation and/or chemotherapy.
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References
Cella D, Pulliam J, Fuchs H, Miller C, Hurd C, Wingard JR, Sonis ST, Martin PJ, Giles F (2003) Evaluation of pain associated with oral mucositis during the acute period after administration of high-dose chemotherapy. Cancer 98:406–412
Cerchietti LCA, Navigante AH, Bonomi MR, Zaderajko MA, Menendez PR, Pogany CE, Roth BMC (2002) Effect of topical morphine for mucositis-associated pain following concomitant chemoradiotherapy for head and neck carcinoma. Cancer 95:2230–2236
Chalmers J, Johnson V (2004) Evidence-based protocol: oral hygiene care for functionally dependent and cognitively impaired older adults. J Gerontol Nurs 30(11):5–12
Chan CWH, Chang AM, Molassiotis A, Lee IYM, Lee GCT (2003) Oral complications in Chinese cancer patients undergoing chemotherapy. Support Care Cancer 11:48–55
Chen C-F, Wang R-H, Cheng S-N, Chang Y-C (2004) Assessment of chemotherapy-induced oral complications in children with cancer. J Pediatr Oncol Nurs 21:33–39
Cheng KKF (2004) Children’s acceptance and tolerance of chlorhexidine and benzydamine oral rinses in the treatment of chemotherapy-induced oropharyngeal mucositis. Eur J Oncol Nurs 8:341–349
Cheng KKF, Chang AM (2003) Palliation of oral mucositis symptoms in pediatric patients treated with cancer chemotherapy. Cancer Nurs 26:476–484
Cheng KKF, Molassiotis A, Chang AM, Wai WC, Cheung SS (2001) Evaluation of an oral care protocol intervention in the prevention of chemotherapy-induced oral mucositis in paediatric cancer patients. Eur J Cancer 37:2056–2063
Cheng KKF, Chang AM, Yuen MP (2004) Prevention of oral mucositis in paediatric patients treated with chemotherapy: a randomised crossover trial comparing two protocols of oral care. Eur J Cancer 40:1208–1216
Clarkson JE, Worthington HV, Eden OB (2003) Interventions for preventing oral mucositis for patients with cancer receiving treatment. Cochrane Database Syst Rev (3):CD000978 (review)
Costa EMMdeB, Fernandez MZ, Quindere LB, deSouza LB, Pinto LP (2003) Evaluation of an oral preventive protocol in children with acute lymphoblastic leukemia. Pesqui Odontol Bras 17(2):147–150
Dahlin C (2004) Oral complications at the end of life. Am J Nurs 104(7):40–47
Daniel BT, Damato KL, Johnson J (2004) Educational issues in oral care. Semin Oncol Nurs 20:48–52
Dodd MJ, Miaskowski C, Greenspan D, MacPhail L, Shih A, Shiba G, Facione N, Paul SM (2003) Radiation-induced mucositis: a randomized clinical trial of micronized sucralfate versus salt & soda mouthwashes. Cancer Invest 21:21–33
Epstein JB, Truelove EL, Oien H, Allison C, Le ND, Epstein MS (2001) Oral topical doxepin rinse: analgesic effect in patients with oral mucosal pain due to cancer or cancer therapy. Oral Oncol 37:632–637
Fulton JF, Middleton GJ, McPhail JT (2002) Management of oral complications. Semin Oncol Nurs 18:28–35
Glenny AM, Gibson F, Auld E, Coulson S, Clarkson JE, Craig JV, Eden OB, Worthington HV, Pizer B on behalf of the UKCCSG-PONF Mouth Care Group (2004) A survey of current practice with regard to oral care for children being treated for cancer. Eur J Cancer 40:1217–1224
Hadorn DC, Baker D, Hodges JS, Hicks N (1996) Rating the quality of evidence for clinical practice guidelines. J Clin Epidemiol 49:749–754
Hancock PJ, Epstein JB, Sadler GR (2003) Oral and dental management related to radiation therapy for head and neck cancer. J Can Dent Assoc 69:585–590
Harris DJ, Knobf MT (2004) Assessing and managing chemotherapy-induced mucositis pain. Clin J Oncol Nurs 8:622–628
Honnor A, Law A (2002) Mouth care in cancer nursing: using an audit to change practice. Br J Nurs 11:1087–1096
Kennedy HF, Morrison D, Tomlinson D, Gibson BES, Bagg J, Gemmell CG (2002) Gingivitis and toothbrushes: potential roles in viridans streptococcal bacteraemia. J Infect 46(1):67–70
Kwong KKF (2004) Prevention and treatment of oropharyngeal mucositis following cancer therapy: are there new approaches? Cancer Nurs 27:183–205
McGuire DB (2003) Barriers and strategies in implementation of oral care standards for cancer patients. Support Care Cancer 11:435–441
Mead GM (2002) Management of oral mucositis associated with cancer chemotherapy. Lancet 359:815–816
Melkos AB, Massenkeil G, Arnold R, Reichart PA (2003) Dental treatment prior to stem cell transplantation and its influence on the posttransplantation outcome. Clin Oral Invest 7:113–115
Rubenstein EB, Peterson DE, Schubert M, Keefe D, McGuire D, Epstein J, Elting LS, Fox PC, Cooksley C, Sonis ST (2004) Clinical practice guidelines for the prevention and treatment of cancer therapy-induced oral and gastrointestinal mucositis. Cancer 100(9 Suppl):2026–2046
Sadler GR, Stoudt A, Fullerton JT, Oberle-Edwards LK, Nguyen Q, Epstein JB (2003) Managing the oral sequelae of cancer therapy. Medsurg Nurs 12(1):28–36
Schiodt M, Hermund NU (2002) Management of oral disease prior to radiation therapy. Support Care Cancer 10:40–43
Scully C, Epstein J, Sonis S (2004) Oral mucositis: a challenging complication of radiotherapy, chemotherapy, and radiochemotherapy. Part 2: diagnosis and management of mucositis. Head Neck 26(1):77–84
Shih A, Miaskowski C, Dodd MJ, Stotts NA, MacPhail L (2002) A review of the current treatments for radiation-induced oral mucositis in patients with head and neck cancer. Oncol Nurs Forum 29:1063–1080
Somerfield MR, Padberg JJ, Pfister DG, Bennett CL, Recht A, Smith TJ, Weeks JC, Winn RJ, Durant JR (2000) ASCO clinical practice guidelines: process, progress, pitfalls, and prospects. Class Pap Curr Comments 4(4):881–886
Turhal NS, Erdal S, Karacay S (2000) Efficacy of treatment to relieve mucositis-induced discomfort. Support Care Cancer 8:55–58
Vered M, Dayan D, Buchner A (2004) Treatment modalities for chemo- and radiotherapy-induced oral mucositis—critical analysis and practical guidelines. J Israel Dent Assoc 21:19–28
Wohlschlaeger A (2004) Prevention and treatment of mucositis: a guide for nurses. J Pediatr Oncol Nurs 21:281–287
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The coauthors contributed equally to the work described in this paper.
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McGuire, D.B., Correa, M.E.P., Johnson, J. et al. The role of basic oral care and good clinical practice principles in the management of oral mucositis. Support Care Cancer 14, 541–547 (2006). https://doi.org/10.1007/s00520-006-0051-8
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DOI: https://doi.org/10.1007/s00520-006-0051-8