10 Things You Didn’t Know about Mucositis

The majority of all patients diagnosed with oral cancer, as well as those receiving radiation for cancers of the head, mouth, and neck, develop mucositis during their treatment. Mucositis is an infection of the mucosa, membranes that line the passages of the body that come into contact with the air, including the inside of the mouth and throat.

The danger of mucositis infections is that, in the advanced stages, they make it impossible for patients to continue with treatments. For that reason, the treatment and management of mucositis is a top priority for oncologists and cancer patients alike.

Because mucositis is not particularly common in the general population, it may be helpful to present some little-known facts about this troublesome and painful disease.

  1. Patients who have low levels of saliva (a condition known as hyposalivation) before and during treatment are more likely to develop mucositis than patients with normal levels of saliva. Hyposalivation can be caused by a variety of things, including certain medications, dehydration, anxiety, and smoking.
  2. In cancer patients who develop mucositis, the onset generally occurs within six to ten days of the start of chemotherapy, and can last anywhere from one to six weeks. When the disease reaches advanced levels (stages three and four) chemotherapy must usually stop until the patient’s white cell counts have returned to acceptable levels.
  3. When a patient is preparing to receive chemotherapy or radiation, he can minimize his chances of developing mucositis by making an appointment to see a dentist who has experience treating cancer patients. A qualified dentist will make sure that all necessary dental work is completed in time to allow the mouth to heal before treatment. He can also double-check the fit of dentures.
  4. One very simple preventive measure that can help delay mucositis or reduce its severity is rinsing the mouth with saline (salt water), which helps in two ways. First, it helps keep the mouth moist by introducing liquid. Second, it can help facilitate the healing of existing wounds. Mucositis results in the presence of painful, open sores in the mouth. Just as salt water can help canker sores and other injuries to heal, it can do the same for mucositis sores. Rinsing with salt water in the early stages of mucositis can help prevent the disease from advancing to the point where treatments must be halted.
  5. Some popular dental hygiene products can increase the chances that a patient will develop mucositis. For example, whitening toothpastes can be very harsh. They dry out the mouth and can help to create an ideal environment for the development of mucositis. The same thing is true of harsh mouthwashes, particularly those containing alcohol. Patients who are receiving cancer treatments should use mild toothpaste with a soft toothbrush, and stick to non-alcoholic mouthwash.
  6. Some cancer patients find that they can keep their mouths moisturized and reduce their risk of developing mucositis by doing small, common sense things. Some examples include sucking on ice chips during treatments, which is sometimes referred to as cryotherapy. Others find that sucking on tart, sugar-free candy or chewing sugar-free gum can be helpful. If those things do not work, another alternative is using an over the counter artificial saliva. It is important to note that avoiding sugary foods and beverages is essential, as sugar can increase the likelihood of developing mucositis.
  7. Patients who have mucositis – or are at risk to develop it – can help keep their mouths moist and clean by brushing teeth more frequently than they usually do. Most people brush two or three times per day after meals. Brushing every four hours, and using a soft toothbrush and gentle toothpaste, can help keep saliva production high and reduce the risk of food particles getting caught between teeth and gums.
  8. In very severe cases of mucositis, patients may end up with a layer of white mucous in the mouth up to one millimeter thick. It coats the tongue and inside of the mouth, making it difficult and painful to eat. Even the act of chewing food can be a challenge, and swallowing can be extremely painful. In such instances, patients may require a treatment known as oral debridement, which requires swishing a mucolytic agent in the mouth to remove dried secretions.
  9. Certain foods may irritate the mucosa, thus increasing the chances that a patient will develop mucositis. It is best for patients who are receiving chemotherapy or radiation to avoid eating very spicy foods, coarse foods, citrus fruits, foods with citric acid (such as tomatoes), very hot foods (let food cool before eating it), and very cold foods. Sucking on ice chips is fine, but it is important to make sure they are small chips, not big chunks of ice that might result in an irritation.
  10. Patients who are receiving chemotherapy and radiation, particularly radiation of the head, neck, or face, should make a point of checking the inside of their mouths once a day during treatment so they can spot the early warning signs of mucositis. Some of the signs include: red, shiny gums; a feeling of dryness or pain when eating; difficulty chewing or swallowing; blood in the mouth; sores on the gums, tongue, or inside of the mouth; pus in the mouth or on the tongue; and a thickening of mucous or saliva in the mouth. Patients who experience these symptoms should let their doctors know right away.

There is no denying that radiation-induced mucositis is an uncomfortable and painful condition. Every patient who is undergoing chemotherapy or radiation treatment should be aware of the risks involved with developing mucositis. In its advanced stages, mucositis can lead to treatments being suspended, something that is very dangerous as it may allow malignancies to grow. Patient education is essential, and it is something we take very seriously at Healios.

Our signature product, Healios Glutamine Complex, is proven to help delay the onset of mucositis in cancer patients, and to reduce its severity as well. Click here to learn more.