RESEARCH UPDATES 11 May 2021

Management of oral mucositis and burning mouth:

Oral mucositis is a severely disabling condition, which is commonly seen as an adverse effect after chemotherapy and radiotherapy used in cancer treatment. Oral mucositis can lead to an inability to tolerate food or fluids, which leads to malnutrition, dehydration, and weight loss.

Guidelines on Oral Mucositis (2019):

The guidelines published in 2019 recommend Benzydamine mouthwash. The guidelines state that Benzydamine is the only anti-inflammatory agent with evidence of prevention of oral mucositis to date.

The expert panel confirmed the existing (2014) guideline on the use of benzydamine mouthwash for the prevention of oral mucositis caused by radiotherapy among head & neck cancer patients.

The expert panel also suggested the use of benzydamine mouthwash for patients receiving radiotherapy – chemotherapy among head & neck cancer patients.

Reference: Systematic review of anti-inflammatory agents for the management of oral mucositis in cancer patients and clinical practice guidelines. Support Care Cancer. 2019 Oct;27(10):3985-3995. doi: 10.1007/s00520-019-04888-w. Epub 2019 Jul 8. PMID: 31286230.

Relevance to dental practice:

Benzydamine mouthwash has been in use for many years. Now, literature gives the much-needed evidence-based confidence to the practitioners that if benzydamine can reduce the severity and provide comfort in a condition as severe as oral mucositis from cancer therapy, it can undoubtedly provide comfort in less severe, day-to-day cases of mucosal erythema, burning and discomfort while having food and fluids.

Any mucosal burning, pain or discomfort. Symptoms may be vague and take time to arrive at a diagnosis. But Benzydamine can provide instant relief.

Oral submucous fibrosis which causes burning mouth along with restricted mouth opening. Trauma from orthodontic braces, oral surgery appliances where the patient can not apply the local anaesthetic gel, topical steroid gel etc.

Ulcers over a wide area inside the mouth, where applying a gel may not be feasible. Hot food/ beverage or allergic reaction to a food ingredient leading to burning and discomfort that urgently needs relief.