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Oral Mucositis

Oral Mucositis

What is
oral mucositis?

Painful oral lesions come in a variety of forms, from multiple small ulcers to more severe conditions such as oral mucositis. Oral mucositis is characterised by unpleasant, painful ulcers and inflammation in the mouth. 

In some cases oral mucositis can cause severe discomfort or pain and may even prevent swallowing of food and fluids.


Who is affected by oral mucositis?

Oral mucositis can affect people who are receiving radiotherapy and/or chemotherapy for a wide variety of reasons:

  • 85−100% of patients receiving radiotherapy for head and neck cancer
    • 25−45% have severe oral mucositis10
  • 75−100% of patients receiving stem-cell transplantation (chemotherapy is used to prepare the patient's system beforehand)
    • 25−60% have severe oral mucositis10
  • 5−40% of patients receiving treatment for solid tumours with myelosuppressive chemotherapy10

However, the true incidence of oral mucositis may be even higher as oral mucositis that is not classed as 'severe', but which may have an impact on patients' comfort, is not consistently reported.11

What problems can oral mucositis cause?

Oral mucositis doesn't just cause pain; it can also affect disease management and treatment outcomes. Oral mucositis can lead to:

  • Increased risk of infection and fever12
  • Prolonged hospitalisation12
  • Adjustment of anti-cancer therapy11,12
  • Need for artificial nutrition (i.e. a feeding tube)11,12
  • Need for strong painkillers (e.g. opioids)12
  • Increased weight loss12
  • Restricted mouth care13
  • Impaired speech13

Oral mucositis can also have a significant impact on healthcare resources. American studies have estimated extra costs associated with oral mucositis to be in the region of £920 to £3750 per patient,* depending on severity (2006).12,14 

*Based on the results of two US studies.12,14 Figures are converted from US$ using average exchange rates for the period of study data collection.

What causes oral mucositis?

Oral mucositis is caused by a breakdown of the oral mucosa usually related to chemotherapy or radiotherapy. The diagram below shows how this happens.

When do symptoms develop?

Chemotherapy: symptoms usually develop on day five, peaking after seven to ten days.15

Radiotherapy to the head and neck: symptoms will usually start one to two weeks after first dose of radiotherapy and usually continue for one to three weeks after therapy is completed.15


How is oral mucositis managed?

Management strategies for oral mucositis include:

  • Bland rinses16
  • Topical anaesthetics16
  • Analgesics16
  • Keratinocyte growth factor-116
  • Low level laser treatment17
  • Mucosal coating agents, such as Gelclair®16

Gelclair® is an oral gel that helps to relieve the pain associated with oral mucositis and other treatment-related oral lesions.1-3 Gelclair® does this by forming a bioprotective coating inside the mouth, offering rapid and effective pain management.1-3,5-9 

To find out more about how Gelclair® works and the clinical evidence supporting it, click here or click on the "About Gelclair®" tab at the top of the page.


Encouraging meticulous oral hygiene is important in preventing and managing oral mucositis. The joint Multinational Association of Supportive Care In Cancer (MASCC) and International Society of Oral Oncology (ISOO) guidelines (2007) for oral mucositis recommend:17

  • Initial and ongoing assessment of the oral cavity using validated instruments that include both patient self-report and professional examination
  • Regular, systematic, oral care hygiene with brushing, flossing, bland rinses and moisturisers using a standardised oral care protocol should be implemented for all patients
  • Use of a soft toothbrush, replaced on a regular basis
  • Dental examinations and treatment prior to the start of cancer therapy for all patients, especially those with head and neck cancer, which should continue throughout active treatment and follow-up.