Prevention

Preventative Practices

Basic Oral Hygiene

Good oral hygiene can decrease infection the risk of the mouth being a target for chemotherapy due to on-going inflammation from infection and/or trauma.

Cryotherapy

The use of ice or popsicles can cause vasoconstriction, reducing blood flow to the mouth and potentially inhibiting the delivery of chemotherapy that travels through the blood into the oral cavity.

Mouth Rinses

• NaCl Rinse: ½ tsp (2.5ml) of salt in 8 oz of water
• NaBicarb: ¼ to ½  tsp (1.25-2.5mL) baking soda in 8 oz of water
• Mixed NS/Sodium bicarb solution: ¼ tsp of salt +1/4 tsp baking soda in 8 oz of water
• Chlorhexidine:
  • 6-12 yrs old swish and spit 5-10ml 3-4 times daily
  •  >12 yrs old : swish and spit 15ml 3-4 times daily

First, the use of rinsing the mouth helps to reduce the amount of time the chemotherapy spends in contact with the oral tissue reducing the risk of tissue breakdown. Secondly, oral rinses help to improve oral hygiene by removing food and plaque build-up that can promote inflammation. Chemotherapy is naturally attracted to inflamed tissue, thus reducing inflammation of the mouth can decrease the risk of oral tissue (mucosa) becoming a target.

Lip Balm

Lubrication of the oral mucosa and prevention of dryness can help to decrease risk of cytotoxic damage from chemo since dryness and/or peeling can increase inflammation that is targeted by chemotherapy.

• The following options can be used: VASELINE^®, A&D^® ointment, VICKS^®, ChapStick^®, etc.

L-Glutamine (Endari)

L-glutamine is the most abundant amino acid in the body that improves production of IgA antibody that lines the GI mucosal lining increasing protection against bacterial and translocation of microbes that can occur when there is mucosal damage or breakdown from chemo and/or radiation. It also aids in promoting more rapid healing of damaged tissues. Additional benefits are increases brain function, energy and digestion.

• 400mg/kg/day divided into twice daily dosing