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Oral Mucositis
Aka: Oral Mucositis, Stomatitis
- See Also
- Oral Ulcers
- Pharyngitis
- Definitions
- Stomatitis
- Inflammation of the mouth and lips
- Broader term that includes Oral Mucositis
- Mucositis
- Painful inflammation and ulceration of the gastrointestinal tract
- Typically caused by Chemotherapy or Radiation Therapy
- Causes: Stomatitis
- Vitamin Deficiency (typically associated with recurrent Aphthous Ulcers)
- Iron Deficiency Anemia
- Vitamin B1 Deficiency (Thiamine deficiency)
- Vitamin B2 Deficiency (Riboflavin deficiency)
- Vitamin B6 Deficiency (Pyridoxine deficiency)
- Vitamin B9 Deficiency (Folic Acid Deficiency)
- Vitamin B12 Deficiency (Cobalamin Deficiency)
- Specific lesions
- Angular Stomatitis
- Aphthous Stomatitis
- Herpes Gingivostomatitis
- Nicotinic Stomatitis
- Acute Necrotizing Ulcerative Gingivitis (Vincent's Stomatitis)
- Local Trauma or reaction (e.g. ill-fitting dentures, Contact Dermatitis)
- Oral Mucositis associated with Chemotherapy or Radiation Therapy
- May be complicated by Oral Candidiasis (Thrush) or Herpes Gingivostomatitis
- Management
- See Oral Ulcer
- See Pharyngitis Symptomatic Treatment
- Treat specific causes
- Angular Stomatitis
- Aphthous Stomatitis
- Herpes Gingivostomatitis
- Symptomatic management
- Saline rinses
- Prepare one teaspoon salt in 32 ounces water
- Some recipes recommend adding bicarbonate
- Topical over-the-counter agents
- Amphojel (coats lesions)
- Zilactin (forms film over the lesion)
- Topical prescription agents (expensive)
- Episil (viscous gel)
- Mugard (oral rinse)
- Gelclair (viscous gel)
- Consider topical combination agents
- Magic Mouthwash
- Typically compounded (e.g. Lidocaine, Benadryl, maalox, with or without a Corticosteroid and/or antibiotic)
- First Mouthwash BLM (commercially prepared)
- Diphenhydramine, Lidocaine, Maalox, and Simethicone
- Avoid unhelpful or harmful agents
- Avoid sucralfate (ineffective)
- Avoid chlorhexidine (ineffective)
- Avoid Alcohol-based rinses (may exacerbate pain)
- Avoid hydrogen peroxide (may delay healing)
- References
- Negrin in Drews (2014) Oral Toxicity Associated with Chemotherapy, UpToDate, accessed online 11/05/2014
- (2014) Presc Lett 21(11): 64
- Nolan (1991) J Oral Pathol Med 20(8):389-91 [PubMed]
- Sun (2014) J Oral Pathol Med [PubMed]
- Thongprasom (2001) Southeast Asian J Trop Med Public Health 32(3):643-7 [PubMed]