Mucositis refers to mucosal damage in the oropharyngeal cavity. Oral mucositis is an inflammatory response which occurs as a result of destruction of the mucosal or glandular cells within the head and neck area.79
When the salivary glands are included in the radiation treatment field, salivary secretion decreases rapidly, particularly if the parotid and submandibular glands are irradiated80, 81. As the radiation treatment accumulates, the mucosa becomes denuded, then ulcerated, and covered with an exudate.81, 82
Mucositis affects eating and nutrition and causes pain and sensations of coughing and choking. Changes in saliva, taste, and pain impact on an individual's quality of life.30 The degree of mucositis and vulnerability of the individual depends on treatment factors such as:30
- radiation regimen
- area and volume
- anatomic location.
Individual factors that increase risk of mucositis include:30
- oral hygiene
- smoking / alcohol
- poor dental hygiene
- traumatising agents, i.e. dentures
- large amalgam fillings
- fungal infections.
Distress from the symptoms of mucositis may be reduced by providing information, early assessment and support to provide symptomatic relief and prevent secondary infections. Assessment of the oral cavity before treatment may eliminate sources of infection and chronic irritation.30
Prior to radiation to the head and neck area, individuals should have an assessment with a dentist, and diseased teeth should be removed. If healthy teeth remain in the treatment field, the patient should begin daily fluoride treatment to prevent the development of future dental caries.72
Access the eviQ Resource Document Oral Mucositis – Assessment and Treatment and:
- Summarise current recommendations for the prevention and treatment of oral mucositis in individuals receiving radiation therapy
- Appraise the oral assessment process within your health care facility.