Muscositis
Initial Signs and Symptoms
- Red, shiny or swollen mouth and gums
- Soft white patches or pus in the mouth or on the tongue
- Sores in the mouth, on the gums or on the tongue
- Blood in the mouth
- Difficulty swallowing or talking
- Feeling of dryness, mild burning, or pain in mouth or throat when eating
- Increased mucus or saliva in the mouth
Risks of Mucositis:
- Pain
- Infection: portal of entry for organisms
- Dehydration/ Malnutrition: restricted oral intake
- Contributes to interruption of medical therapy
- May increase use of antibiotics and opioids
Prevention
- Ice Chips
- Systematic approach to oral care to reduce infection, bleeding and microbial flora
- Some evidence that low level laser Therapy may reduce the incidence
Management
- Assess the mouth frequently! Rigorous assessment and early intervention is key
- Rinse mouth well after every meal
- Texture as tolerated and choose high calorie, high protein fluids
- Use a soft bristled toothbrush to clean the teeth
- Avoid foods that irritate the mouth or throat (e.g. abrasive, acidic, salty, spicy etc.)
- Use of Oral Balance(saliva product)
- Systemic analgesia with a strong opioid is the recommended treatment for oral mucositis
- Ice chips or popsicles to numb the area
- Remove dentures whenever possible and clean thoroughly
- Patient and family health teaching
- Use of a gentle rinsing solution (1 tsp. salt, 1 teaspoon baking soda in 1 liter/4cups of water prepared once daily and notrefrigerated)
- Topical anaesthetics (e.g. viscous lidocaine 2% or viscous xylocaine 2%, 2-5 ml.) before eating and before brushing
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