| Oral hygiene |
Establish a tooth brushing routine using a small and soft brush. |
Level III |
| Brush tongue delicately (for prevention only, i.e. without installed mucositis). |
Level III |
| Floss whenever possible (will depend on blood count result and oral mucosa assessment). |
Level III |
| Use non-abrasive toothpaste, preferably containing baking soda and/or fluoride. |
Level V |
| Tooth brushing after meals and before going to bed. |
Level III |
| Remove dental prostheses and wash them 30 minutes after meals and at night. |
Level III |
| Assess the evolution of the injuries and advise on oral hygiene maintenance. |
Level III |
| Maintain oral hygiene, only avoiding tongue brushing (in case of installed mucositis). |
Level III |
| Suspend use of dental prostheses (if these exist) in case of oral mucosa injuries. |
Level III |
| Put a piece of gauze around the finger for oral hygiene if the patient feels pain and is unable to brush. |
Level VII |
| Mouthwash |
Rinse with 0.9% saline solution or 3% water with baking soda, 4 to 6 times per day. If the patient cannot buy mouthwash, the institution can provide it, as it is available nowadays. |
Level V |
| Advise on rinsing with 2% morphine solution to treat the pain due to oral mucositis in clients, patients will receive chemoradiation for head and neck cancer. |
Level III |
| Advise not to use antimicrobial mouthwash to prevent oral mucositis in clients who will receive high doses of chemotherapy or in people who will receive concomitant radiation therapy or chemotherapy for head and neck cancer. |
Level II |
| Cryotherapy |
Forwarding for oral cryotherapy can be used to prevent oral mucositis in patients who received a high dose of melphalan, with or without full body radiation, as the conditioning for the transplantation. |
Level III |
| Forward for 30 minutes of oral cryotherapy used to prevent oral mucositis in clients who received intravenous chemotherapy in a bolus of 5-fluorouracil. |
Level II |
| Laser therapy |
Forward for laser 40 mW to prevent oral mucositis in clients who will receive bone marrow transplantation, conditioned with high doses of chemotherapy. |
Level II |
| Nutritional interventions |
Consume foods cold or at room temperature, including jelly and non-acid fruit sorbets. |
Level V |
| Avoids foods that irritate the oral mucosa, such as citric juice, spicy or very salty and coarse and dry foods |
Level V |
| Consume foods that are easy to chew and swallow, in the form of mashes and creams, including bananas and other soft fruits; and fruits rich in liquid, such as watermelon. |
Level V |
| Cook food until soft and mild. |
Level V |
| Increase fluid intake, as well as fluid content of foods, adding meat sauce, meat stock, or non-spicy sauces. |
Level IV |
| Forward the client for monitoring with nutritionist with respective evaluation records of mucositis, certifying inability to consume foods and fluids orally. |
Level II |
| Contact physician about client's situation and require assessment for possible placement of nasoenteral probe. |
Level II |
