Mucositis I

Question 1

What are the general measures a chemo patient should undertake to help prevent oral mucositis?

Answer 1

Inspect oral mucosa daily
Ask dentist to remove sources of trauma (fractured teeth, ill fitting prosthesis etc.)
Lubricate lips with non-occlusive agent
Drink ample fluids to keep mouth moist

Question 2

Why is it not advisable for chemo patients to use petrolatum based lubricants?

Answer 2

They promote mucosal dehydration and are occlusive leading to risk of secondary infection

Question 3

Why is it important for chemotherapy patients to request their dentists remove any sources of trauma from their mouth?

Answer 3

To reduce the risk of developing oral mucositis

Question 4

What type of toothbrush is best to be used by chemotherapy patients at risk of oral mucositis?

Answer 4

Soft brush

Question 5

How often should patients undergoing chemotherapy at risk of oral mucositis change their tooth brush?

Answer 5

Monthly

Question 6

When and how often should chemo patients clean their teeth?

Answer 6

after meals and before sleep

twice a day

Question 7

If chemo patients cannot tolerate a soft brush what else can they use to clean their teeth?

Answer 7

A swab

Question 8

What type of toothpaste should they use to clean the dentition and gingiva?

Answer 8

Mild fluoride containing, non-foaming toothpaste

Question 9

How should patients clean their teeth if they use a manual brush?

Answer 9

Bass or modified bass method

Question 10

How should patients clean their teeth if they use an electric toothbrush?

Answer 10

According to product instructions

Question 11

How should patients clean and store their brushes?

Answer 11

Clean brush thoroughly after use with water and store in a cup with brush head upwards

Question 12

Should patients clean in between teeth e.g. using floss?

Answer 12

Only if they are used to doing so prior to Chemo treatment

Question 13

Why should patients who do not normally clean between teeth (e.g. with floss etc) not start to do this once they have commenced chemotherapy?

Answer 13

It can break the epithelial barrier - visible through gingival bleeding

Question 14

What type of mouthwash is recommended for chemotherapy patients?

Answer 14

Alcohol free mouthwash

Question 15

When and how often should a patient use mouthwash?

Answer 15

On awakening and at least four times a day after brushing

Question 16

How long should you hold the mouthwash in the mouth for?

Answer 16

1 minute

Question 17

How much mouthwash should you use?

Answer 17

15 ml

Question 18

Is it ok to eat after using mouthwash?

Answer 18

Avoid eating or drinking for 30 minutes after using mouthwash

Question 19

How should dentures be treated?

Answer 19

Remove dentures, brush with toothpaste and rinse with water, clean the gums

Question 20

What precautions should be taken with dentures whilst in hospital?

Answer 20

Defer wearing dental prostheses as much as possible until the lining tissues of the mouth are healed
Soak dentures for 10 mins in antimicrobial solution (chlorheaxidine 0.2%) before inserting into mouth

Question 21

What painful stimuli should be avoided to reduce the risk of oral mucositis?

Answer 21

Smoking
Alcohol
Certain foods (tomatoes, citrus fruits, hot drinks, spicy foods, hot, raw or crusty foods)