Congress Abstracts 2005

19

ORAL ASSESSMENT: DIFFERENTIATING BETWEEN MUCOSITIS AND STOMATITIS. Jessica Richard, RN, BSN, OCN^®, Mildred “Millie” Toth, MS, RN, OCN^®, AOCN^®, and Bella B. Toth, MS, DDS, The University of Texas M.D. Anderson Cancer Center, Houston, TX.

Approximately 40% of patients receiving chemotherapy develop complications of the oral mucosa. In BMT/SCT patients, the percentage increases to 80%. Oral mucositis and stomatitis are painful, debilitating complications that can affect the patient psychologically and physically. In addition, the duration and intensity of treatment protocols may be altered because of mucositis and both its treatment and/or dose limiting toxicities. The oncology nurse’s ability to assess for and differentiate between mucositis and stomatitis is essential to the appropriate management of these 2 distinct oral complications.

The purpose of this presentation is: (1) to educate the oncology nurse on the differences between mucositis and stomatitis; (2) to identify the most common risk factors associated with mucositis and stomatitis; (3) to demonstrate the appropriate assessment of the oral cavity and (4) to discuss the current trends in the treatment and prevention of oral mucositis. Current literature does not usually differentiate between mucositis and stomatitis, although, there is a distinct difference. Mucositis is the chemotherapy and/or radiotherapy induced inflammation of the oral mucosa that represents a separate entity distinct from oral lesions with other pathogenic causes summarized as stomatitis (Peterson, 1999).

The oncology nurse’s assessment of the oral mucosa should include knowledge of the patient’s treatment regime and reception of stomatoxic therapies, or lack thereof, the treatment day as it relates to the patient’s anticipated nadir, and the patient’s history of oral complications. Culturing any suspicious lesions should be a priority and will help differentiate the cause.

Nurses’ knowledge of the distinctions between cancer related mucositis and stomatitis and the ability to appropriately assess for and identify oral lesions and their potential causes can greatly improve the outcomes of treatment.

The current literature identifies a great need for further research into the treatment of oral mucositis. Several different treatments have been proposed but there remains no conclusive data to support one treatment over another. The author of this presentation will present the current trends in assessment and treatment and identify the trends that are the most promising as supported by the literature.