What Causes Mucositis?
Mucositis occurs when cancer treatments break down the rapidly divided epithelial cells lining the gastro-intestinal tract (which goes from the mouth to the anus), leaving the mucosal tissue open to ulceration and infection. Mucosal tissue, also known as mucosa or the mucous membrane, lines all body passages that communicate with the air, such as the respiratory and alimentary tracts, and have cells and associated glands that secrete mucus. The part of this lining that covers the mouth, called the oral mucosa, is one of the most sensitive parts of the body and is particularly vulnerable to chemotherapy and radiation. The oral cavity is the most common location for mucositis.
Oral mucositis is probably the most common, debilitating complication of cancer treatments, particularly chemotherapy and radiation. It can lead to several problems, including pain, nutritional problems as a result of inability to eat, and increased risk of infection due to open sores in the mucosa. It has a significant effect on the patient’s quality of life and can be dose-limiting (i.e., requiring a reduction in subsequent chemotherapy doses). Learn more at Oral Cancer Foundation
The majority of oral cancer patients receiving chemotherapy in combination with radiation will experience at least some degree of mucositis. When caused by chemotherapy, mucositis is usually due to the low white blood cell count; when caused by radiation, mucositis is usually due to the necrotic and inflammatory effect of radiation energy on oral mucosa.
Factors that can increase the likelihood of developing mucositis, or that can make it worse if it does occur, include:
-Poor oral or dental health.
-Smoking or chewing tobacco and drinking alcohol.
-Gender (females appear to be more likely than males to develop mucositis)
-Low body mass index.
-Diseases such as kidney disease, diabetes or HIV/AIDS.
-Previous cancer treatment.
-Chronic irritation from ill-fitting prostheses or faulty restorations can predispose patients to the development of oral mucositis due to local irritation and trauma.
-Generally, patients with hematologic malignancies have an increased rate of oral mucositis compared with those with solid tumors. This is to some extent related to the treatment regimens.
-Hyposalivation prior to and during treatment is associated with an increased risk of oral mucositis.
-The use of methotrexate for chronic GVHD prophylaxis may exacerbate lesions of oral mucositis, although this is less of a concern with newer prophylaxis regimens.
-Oral mucositis occurs independently of oral mucosal infections of viral and fungal etiology, but it may be exacerbated by such concomitant infections.
Younger patients tend to develop oral mucositis more often than older patients being treated for the same malignancy with the same regimen. This appears to be due to the more rapid rate of basal cell turnover noted in children. However, the healing of oral mucositis is also more rapid in the younger age group.
People who undergo oncology treatments, such as chemotherapy or radiation, have a high risk of developing mucositis. If you develop mucositis or it worsens, you may need to increase brushing (with the softest toothbrush possible) to every 4 hours and at bedtime. This will help keep the mouth moisturized and help prevent any infections. It is important to brush and floss very gently. You will want to rinse your mouth frequently with a gentle antiseptic mouth rinse. StellaLife VEGA Oral Care Recovery Kit can help temporarily relieve symptoms associated with the effects of mucositis. Once the symptoms and lesions subside or resolve, continue the use of StellaLife VEGA Oral Care Rinse for daily maintenance. See case studies: "Treatment of Focal Mucositis/Mucinosis" by Dr. Tatch and "Mucositis and Thrush Associated Lesions Treatment" by Dr. Ledger.
-If you smoke, it is extremely important that you stop. Your doctor will be able to help you with smoking cessation products and programs.
-Avoid toothpastes with whitening agents.
-Avoid products that irritate the mouth and gums, such as strong flavored commercial mouthwashes and those with alcohol.
-Keep lips moist with moisturizers. Stellalife Lip Balm. Avoid using Vaseline (the oil base can promote infection).
-Limit use of dental floss. Do not use it if your platelet count is below 40,000.
-Do not use lemon or glycerin swabs or toothbrushes without soft bristles.
-Increase your fluid intake.
-Try to include foods high in protein in your diet.
-If you wear dentures, remove them whenever possible to expose gums to air. Loose fitting dentures can irritate the mouth and gums and should not be worn. Do not wear dentures if mouth sores are severe.
-Cryotherapy, which involves sucking on ice chips during chemotherapy administration, has shown some effect in preventing mucositis caused by 5-FU (fluorouracil) chemo treatments.
Oral cancer patients receiving radiation therapy should examine their mouths at least once a day for redness, sores, or signs of infection. The healthcare team should be notified if you notice worsening sores, white patches, pus, a “hairy” or thick feeling tongue, bleeding in the mouth, or development of a fever (temperature greater than 100.4).
StellaLife VEGA Oral Care Recovery Kit: Adults and children over the age of 6 years. Wash hands. Start 3 days before the treatment, continue throughout the treatment. Upon completion of treatment continue with StellaLife VEGA Oral Care Rinse. Rinse mouth (swish and spit) before and after meals and at bedtime. In addition to StellaLife Rinse use normal saline (1 tsp of table salt to 1 quart of water), or salt and soda (one-half teaspoon of salt and 2 tablespoons of sodium bicarbonate in 1 quart of warm water).
Reviewed in the United States on July 17, 2019
"Met the challenge of cleaning and refreshing mouth in the setting of Chemo and Radiation treatments. Also purchased to assist with Mucositis should this problem arise."
Reviewed in the United States on January 4, 2021
"This product is the only one I’ve found that helps with my dry mouth. I was treated for throat cancer with radiation and chemo. The radiation treatment severely damaged my saliva glands. The dry mouth is so bad that it can easily get to the point where I can’t swallow. Cancer changes things and it will never be like it was before. But Stellalife oral rinse gets it pretty close, at least concerning my dry mouth. It was recommended to me by my radiation oncologist and I have been using it for about a year now. The only complaint I have is that there’s been a couple of times that the product was unavailable or delayed for a few weeks. If I run out and don’t use it for a period of time, it takes quite a while get relief again once I have it."
Reviewed in the United States on July 22, 2020
"I had seven implants in my lower jaw in the early to mid 2000’s. In 2017 I started to have painful gum problems. My regular dentist sent me to another dentist who consulted with yet another dentist and it was determined that the bone around the implants was breaking down. I had developed another problem
that required surgery and radiation. Dr. Eddy and Dr. Coombs got me through that surgery and about five months of radiation using Stellalife Rinse everyday. My gums settled down and kept the pain at a minimum. When I went back to Dr. Coombs, I was referred to an oral surgeon for four surgeries to see. If I could wear a lower denture. Again I was given Sellalife rinse and gel to get from one surgery to the next. The results were positive and I was referred to a prosthodontist in Charlotte. Thanks to Stellalife he is going to be able to fit me with a lower denture! I have three implants that I have to keep swelling
and irritations under control until the final denture is complete, Again Stellalife gel has helped me keep everything under control.by using the gel on a soft toothbrush daily, Stellalife worked where other oral medications didn’t!
With thanks and gratitude," Lucille
This information is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.