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Management of stomatitis
Canadian Family Physician, 09/23/09

O'Brien CP – Most patients who receive head and neck radiation therapy will develop oral complications. A proactive approach using pretreatment oral assessment will help minimize such complications. Review patients’ medications and consider eliminating those that increase the risk of stomatitis. Xerostomia is the most consistent and bothersome side effect of radiation therapy. A preventive approach and early treatment are important. Proper nutrition and hydration are vital.

Stepwise approach to symptoms of stomatitis:

• Coating agents such as bismuth salicylate, sucralfate, or other antacids
• Water–soluble lubricants for mouth and
• Topical analgesics, such as benzydamine hydrochloride
• Topical anesthetics, such as lidocaine viscous (might impair gag reflex for a short period)
• Oral or parenteral analgesics, including opioids if needed, for pain not controlled with above

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