Oral mucositis is the result of cancer patients receiving radiation therapy, antitumor drug therapy or hematopoietic stem cell transplantation during the course of Common complications include various degrees of inflammatory changes, dryness, sensitivity, pain, ulcers and other uncomfortable symptoms of the oral mucosa.
The oral mucosa is epithelial cells, and drugs and radiation during anti-tumor therapy can inhibit the renewal of epithelial cells, Destroy the normal physiological function of the oral cavity and the microbial ecological environment, thereby causing the occurrence of oral mucositis. More severe oral mucositis can cause oral pain, dysphagia, weight loss, dehydration, malnutrition, and reduced quality of life. How to effectively deal with or prevent it during treatment? Here are a few tips for you.
01
Cold therapy (highly recommended)
< span>Low temperature induces oral vasoconstriction, reduces the exposure of oral mucosa to toxic drugs, and has never reduced the incidence and pain relief of oral mucositis caused by antineoplastic drug treatment. Oral mucositis can be prevented by mouth-watering ice cubes or ice water before, during, and after high-dose bolus infusions of chemotherapy drugs with short half-lives. Ice water contains 2 to 3 minutes/time; it contains round ice cubes. During this period, do not suck or swallow hard, so that the ice cubes are rotated in the mouth to keep the mouth evenly cold, and the ice cubes are replaced after melting.
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Notes: Cold therapy is contraindicated in patients receiving oxaliplatin; Cold therapy is not recommended for patients.
02
Nutritional support (strongly recommended )
Nutrition risk assessment Patients at risk of malnutrition should follow the nutritional intervention five recommended by the Chinese Anti-Cancer Association Cancer Nutrition and Supportive Care Professional Committee Nutritional intervention is carried out in a step-by-step mode, but those who can eat orally should choose oral nutritional supplements as much as possible. For patients who cannot chew or swallow orally, enteral nutrition such as tube feeding can be given. For patients who cannot meet the needs of enteral nutrition supplementation, parenteral nutrition can be added. , to reach the target demand.
03
Routine oral care (strong Recommended)
Routine oral care includes:
Oral assessment is performed daily to observe whether there is redness, swelling, erythema, ulcers, pain, etc.
Keep your mouth clean, use a soft-bristled toothbrush and fluoride toothpaste after each meal and before bed, and change your toothbrush frequently.
Rinse your mouth with an alcohol-free salt solution, such as saline, soda, or a mixture of the two.
Avoid foods and beverages that may aggravate mucosal damage, pain, or discomfort, including hot, sour, spicy, rough, and hard foods.
Quit smoking and drinking.
Patients who wear dentures should take proper care of the dentures to reduce irritation to the oral mucosa. Patients with caries should strengthen the cleaning of the residual roots .
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Low-dose laser therapy (weak recommendation)
Low-dose laser therapy can reduce the incidence of severe oral mucositis caused by anti-tumor therapy, and reduce the degree of pain. Low-dose laser therapy below 2J/cm2 The effect of treatment is better than that of low-dose laser treatment above 2J/cm2. This method can be used to prevent or treat oral mucositis in patients with pretreatment before stem cell transplantation or oral radiation therapy.
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05
Honey (weak recommendation)
Mature honey has the characteristics of high acidity and high osmotic pressure, and contains glucose oxidase system, which can inhibit bacterial growth and promote cell epithelial regrowth. It can be used before the start of each radiotherapy and 15 minutes after the end of radiotherapy. and 6 hours after radiotherapy, 15-20 ml/time of honey should be taken, and swallowed slowly after 5 minutes to make the honey fully contact with the oral mucosa.
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Notes: You should choose organic honey that is approved by the Food and Drug Administration and circulated on the market, and does not contain antibiotics, pesticides or other chemical residues that may cause harm. Diabetic patients are contraindicated, Use with caution in breast cancer patients.
06
Chewing gum (weak recommendation)
Chewing gum can promote saliva secretion, prevent dry mouth, and neutralize oral acidity, thereby reducing antitumor drugs The incidence of oral mucositis caused by treatment. Chewing gum can also resist the migratory movement caused by the action of motilin, reduce nausea and vomiting; promote the secretion of digestive juice, thereby enhancing peristalsis and reducing constipation after chemotherapy; economical, convenient, It is easy to accept.
During anti-tumor drug treatment, the patient should rinse his mouth with water after each meal to rinse away food residues, and then choose according to his preference. Chew different flavored chewing gums such as mint and lemon for 5 to 10 minutes each time, and diabetics can choose sugar-free chewing gum.
07
< span data-mpa-emphasize-underline="t">Distilled water gargle (weak recommendation)
recommended every meal during antitumor therapy Rinse mouth with distilled water after and before going to bed. Distilled water is a hypotonic solution, odorless and non-irritating. After oral care, the patient has a comfortable taste and no discomfort such as nausea and vomiting. After normal saline is used for oral care, the water evaporates into a hypertonic solution, and sodium chloride is deposited on the oral mucosa. Epithelial cells shrink and rupture due to dehydration, resulting in drying and bleeding of the mucosa, which further increases and aggravates the incidence of oral mucositis. At the same time, the unique salty taste of normal saline will aggravate the patient’s oral discomfort and nausea and vomiting.
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There are many ways to prevent oral mucositis, but when choosing to use the above recommended methods, you must combine your own Condition and willingness to make judgments and choices. At the same time, it is also hoped that the clinical hospital will conduct more high-quality research in the field of oral mucositis prevention by non-drug interventions such as distilled water gargling, chewing gum, and light therapy in the future.
References
[1] Chinese Cancer Symptom Management Practice Guidelines-Oral Mucositis Xu Pengpeng Lilac Garden Tumor Time
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The information in this article is synthesized from the references.
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