The panel suggests interdisciplinary development of systematic oral care protocols that are geared toward the individual needs of the patient; educational approaches to promulgating them that include the patient, family, and staff; and quality-improvement processes to evaluate them.
It also suggests the use of a soft-bristle toothbrush that is replaced on a regular basis. Based on expert opinion and the limited published literature, the panel recommends the following:
- Regular assessment of oral pain is essential and should be performed using validated, self-report pain instruments. Topical protective agents or anesthetics should be considered to promote oral comfort.
- Use of a preventive oral care regimen should be part of routine supportive care along with a therapeutic oral care regimen if mucositis develops.
Regular, systematic, oral care hygiene with brushing, flossing, bland rinses, and moisturizers using a standardized oral care protocol should be implemented for all patients.
Dorothy M. Keefe, Mark M. Schubert, Linda S. Elting, Stephen T. Sonis, Joel B. Epstein, Judith E. Raber-Durlacher, Cesar A. Migliorati, Deborah B. McGuire, Ronald D. Hutchins, Douglas E. Peterson.
- Multinational Association Mucositis Study Supportive Care in Cancer International Society Oral Oncology - Dept of Medical Oncology Royal Hospital Adelaide - Australia.
- School of Dentistry, University of Washington
- Dept of Biostatistics - University of Texas
- Cancer Center, Houston Texas
- Dept of Surgery Research, Brigham Women’s Hospital, Boston, Massachusetts
- Dept of Hematology, Leiden University Medical Center, Leiden, the Netherlands
- Dept of Diagnostic Sciences, NOVA
- Southeastern University, Fort Lauderdale, Florida
- School of Nursing, University of Maryland, Baltimore, Maryland
- Res Med Library, University of Texas
- School of Dental Medicine, Univ. of Connecticut Health Center, Farmington, Connecticut.
Fonte: American Cancer Society