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Oral $MENU
mucositis
Last reviewed:October 2019
Last updated:June 2018

Summary
An acute inflammation of the oral
mucosa following systemic
chemotherapy and/or radiation.
Diagnosis is typically based on
clinical history and physical
exam....
READ MORE#

Definition
Oral mucositis secondary to
cancer therapy is an acute
inflammation of the oral mucosa
in response to systemic
chemotherapy and/or radiation to
fields involving the oral cavity. The
clinical presentation ranges from
a general erythematous stomatitis
to erosive lesions and overt
ulceration. Lesions are often very
painful, may compromise nutrition
and oral hygiene, and can
increase the risk of local and
systemic infection. Furthermore,
severe oral mucositis may
necessitate an undesirable
chemotherapy dose-reduction
and/or a break in radiation
therapy. Therefore, mucositis is a
highly significant complication of
cancer therapy, with a potential
impact on patient prognosis.[1]

Mucositis: dorsolateral tongue

From the teaching collection of
Rajesh V. Lalla, DDS, PhD,
CCRP, DABOM; used with
permission

Mucositis: buccal mucosa

From the teaching collection of
Rajesh V. Lalla, DDS, PhD,
CCRP, DABOM; used with
permission

History and exam

Key diagnostic factors

erythema or ulceration of oral

mucosa
oral pain
Full details

Other diagnostic factors

dietary impairment
diarrhea
xerostomia
fever
Full details

Risk factors

intensive chemotherapy
regimens
radiation therapy to the oral
cavity
chemoradiation
genetic polymorphisms in drug
metabolic enzymes
Full details

Diagnostic investigations

1st investigations to order

clinical diagnosis
Full details

Investigations to consider

CBC and differential

blood cultures
superficial smear of lesion for
microscopy
fungal culture
Full details

Treatment algorithm
INITIAL

undergoing hematopoietic stem

cell transplant: preventive
measures

receiving bolus fluorouracil:

preventive measures

receiving radiation therapy to

oral cavity: preventive
measures
ACUTE

active mucositis

Contributors
Authors

# Rajesh V. Lalla, DDS, PhD,

DABOM

Peer reviewers

# Michael Brennan, DDS, MHS

# Maria Michelagnoli, MB ChB,

MD, FRCPCH

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© BMJ Publishing Group 2018

ISSN 2515-9615

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