Canterbury DHB

Context

Mucositis

Mucosal atrophy and ulceration are common in leukaemic and bone marrow transplant patients. To make the patient more comfortable, reduce local trauma as much as possible, e.g. atraumatic diet, remove ill-fitting dentures, use a Tepe special care soft brush.

Warm saline mouthwashes are often a useful addition for pain relief.

In This Section

Topical Pain Relief

Systemic Pain Relief

Suspected Herpes Simplex

Angular Cheilitis

Lip Care

Xerostomia

Oral cryotherapy for the prevention of high dose melphalan induced stomatitis

Topical Pain Relief

Systemic Pain Relief

Morphine treatment for mucositis: see Pain Management.

Suspected Herpes Simplex

Take swabs for herpes simplex DNA. Valaciclovir should be started before the results of investigations are available if the clinical suspicion is strong.

Angular Cheilitis

Two organisms are usually involved: either S. aureus or candida. Therefore, a swab of the angular fold is indicated to distinguish between the organisms. Moist creases at the angle of the mouth as well as immunosuppression predispose patients to angular cheilitis. Simple “waterproofing” of the mouth creases can often help to alleviate the problem, e.g. Vaseline, barrier cream.

Lip Care

Barrier creams are often water-soluble and do not last long. Therefore a waxy lip balm such as Chapstick® or Vaseline® may be used. Xylocaine ointment (2% lignocaine) can be useful, as it is waxier if lips are cracked.

Xerostomia

To ease the discomfort of dry mouth:

Oral cryotherapy for the prevention of high dose melphalan induced stomatitis

About this Canterbury DHB document (4986):

Document Owner:

Ruth Spearing and Sarah Metcalfe (see Who's Who)

Issue Date:

November 2016

Next Review:

November 2018

Keywords:

Note: Only the electronic version is controlled. Once printed, this is no longer a controlled document. Disclaimer

Topic Code: 4986