Clinical practice guidelines for the prevention and treatment of Mucositis

Basic oral care and good clinical practice principles.

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