Guidelines for Complications of Cancer Treatment Vol VIII Part B

Oral care protocol1. Brush all tooth surfaces for at least 90 seconds, twicedaily using soft brush. Allow tooth brush to air dry beforestoring.2. Floss at least once daily.3. Rinse mouth 4 times.4. Avoid alcohol, tobacco or irritating foods (acidic, hot,rough, spicy).5. Use water based moisturizer for lips.6. Maintain adequate hydration.Oral rinse: salt and sodium bicarbonate gargles: one tea spooneach of salt and sodium bicarbonate per pint of water (LOE 1)Benzydamine hydrochlorideNonsteroidal drug with analgesic, anesthetic, antiinflammatoryand antimicrobial properties. Rinse the oralcavity with benzydamine 15ml- 8-10 times.Cryotherapy: Ice chips or ice cold water for prevention ofmucositis. Useful in patients receiving high dose chemotherapyregimens.Pain managementIncludes use of topical analgesics, anesthetics as well assystemic agents. In severe mucositis pain controlled analgesiawith morphine may be considered.Radiation therapy:Use of conformal blocks to avoid mucosal radiation, 3Dconformal therapy and intensity modulated radiation therapymay reduce high doses to the mucosa.PaliferminRecombinant human keratinocye growth factor that stimulatesgrowth of epithelial cells.181