Mucositis is an irritation of the mucous membranes lining the oral cavity. It can lead to ulcers (or canker sores) that appear in the mouth or throat. This inflammation of the mucous membrane is often a consequence of chemotherapy and radiotherapy treatments. Without valid treatment, however, it is possible to minimize them through good dental hygiene.

Inflammation of the mucous membranes of the mouth or digestive system, mucositis is manifested by redness, pain and canker sores. Mucositis often appears as a side effect of chemotherapy or radiation therapy.

When mucositis progresses to a severe form, it can cause significant pain in the patient, which may interfere with the smooth running of the treatment. In radiation therapy, this side effect often occurs when the rays are directed to an area near the throat or neck.

Mucositis is one of the most common disorders when the patient is treated with chemotherapy or radiation therapy.

This annoying disorder irritates the lining of the oral cavity or esophagus and can lead to ulcers (canker sores). In the esophagus, we then feel a sore throat.

Mucositis most often appear as a side effect of chemotherapy and radiotherapy treatments. The inflammatory process that causes mucositis is initiated by the production of free radicals, molecules used in chemotherapy. These free radicals act directly on the mucous membrane and the vessels, damaging them.

Mucositis is more common with certain medications, and so with the type of chemotherapy. Their frequency may also depend on the doses administered and the duration of treatment.

There are also appearance factors that depend on the patient himself:

• children;
• people over the age of 50;
• the women.

These people are the most susceptible patients to mucositis. Smokers, alcohol users, and diabetics are more likely to develop mucositis.

Genetic factors can finally predispose patients to have more important mucositis.

Dental hygiene plays a role in the appearance of mucositis, as well as whether or not you smoke. By stopping smoking while taking chemotherapy, the frequency and severity of this side effect can be significantly reduced.

It is the action of certain chemotherapy and radiotherapy molecules which are at the origin of mucositis. These molecules contained in drugs act against cells by a cytotoxic action, in order to destroy cancer cells.

However, it can also target healthy cells in the body, especially the epithelial cells that line the walls of the mouth and esophagus. The cytotoxic action induces a modification in the renewal of these cells, and thus alter the mucous membranes of the mouth and the digestive system.

The drugs taken during these therapies, as well as the rays perceived by the body will accentuate the inflammation on healthy cells and increase the severity of the lesions. Usually appearing during the first days of treatment, the inflammation will then gradually decrease, but may recur if treatment with chemotherapy or radiotherapy is continued.

The patient, bothered by this disorder, may have to eat less because of this irritation. The possible loss of weight or malnutrition which results from it can be an obstacle to the good progress of the envisaged therapy. Doctors treating the patient with chemotherapy may then decide to reduce the doses or temporarily suspend the patient.

Preventive or curative treatments do not exist against mucositis: several drugs have been tested, but their effectiveness is only very limited.

Different treatments limiting the painful and undesirable effects of mucositis are available:

• Perform an oral check-up with a specialist: the objective is to look for risk factors linked to poor oral hygiene (cavities) or xerostomia (dry mouth);
• Perform mouthwashes with alcohol-free solutions, and with baking soda after meals;
• Sucking ice cubes or sorbets, water ice for half an hour (the action of vasoconstrictor cold limits the exposure of the mucous membranes of the mouth to drugs);
• Brush your teeth after each meal and before bedtime;
• Avoid alcohol, which accentuates the pain, as well as tobacco;
• Treat dry mouth: hydrate well (at least 2 liters per day) and consume sugar-free chewing gum or candy, saliva substitutes;
• Moisturize your lips, use a non-menthol toothpaste, and a soft (non-electric) toothbrush.

Beyond these measures related to oral health, we can also observe dietary measures that will limit the appearance and severity of mucositis:

• eat slowly, and in small pieces;
• eat frequent and light meals;
• eat foods that are not very hot or at room temperature (not hot);
• avoid hard and crunchy foods (oilseeds, crisps, hard candies, etc.);
• eat preferably chopped foods (meat, vegetables, mixed or chopped fruit, baby food, milkshakes, juice, etc.);
• avoid acidic foods and spices, as well as alcohol and tobacco;
• use a straw for drinking, to prevent the drinks from coming into contact with the lesions.