MUCOSITIS

Mucositis is a lesion of the mucous membranes of the oral cavity.

WHY DOES MUCOSITIS OCCUR?

The main reason for the development of mucositis is the weakening of the immune system after antitumor treatment (chemotherapy or radiation therapy), resulting in impaired regeneration of the epithelium with the formation of ulcers (ulcerative stomatitis). These lesions are a good environment for the active colonization of fungi and opportunistic microflora, which is rich in the oral cavity.

Radiation or chemotherapy destroys the protective barrier of the mucous membrane, which leads to the penetration of substances from the oral cavity into the submucosa and affects the nerve endings – pain syndrome, chronic non-infectious inflammation occurs. This barrier consist of hyaluronic acid, chondroitin sulfate and other  glycosaminoglycans. That’s why local administration of hyaluronic acid and CS can be helpful.

Mucositis can also occur after the implant’s insertion, most often the disease occurs in the first three months after implantation. This is the so-called peri-implant mucositis. It is caused by bacteria that create a microbial plaque on the implant.

RISK FACTORS FOR THE DEVELOPMENT OF MUCOSITIS

Oral mucositis is most likely to develop if the following disorders are present in the body:

•     Liver and kidney diseases
•     Folic acid deficiency
•     Non-compliance with oral hygiene
•     Other diseases of teeth and gums
•     Bad habits (smoking, alcohol abuse)

SYMPTOMS OF MUCOSITIS

Oral mucositis is characterized by:

•     Single sores.
•     White plaque on the mucous membrane.
•     It is accompanied by itching, burning, or pain while eating or talking.

The first symptoms of the disease appear, as a rule, 3-10 days after the start of antitumor treatment.

PHASES OF MUCOSITIS DEVELOPMENT

The following stages of the disease development are distinguished:

0 – Incubation period: plaque is just beginning to form.

1 – slight discomfort when talking or eating, slight redness, isolated lesions of the mucous membrane.

2 – pain increases when talking, eating, and puffiness becomes apparent.

3 – the pain syndrome increases, bleeding appears.

4 – severe pain, constant bleeding, and inflammation begins to spread to hard tissues.

COMPLICATIONS AFTER MUCOSITIS

The appearance of mucositis can complicate the course of the underlying disease. Why is this happening?

•     Secondary infection increases the risk of sepsis.
•     Extensive necrosis of the mucous membrane can cause intense bleeding.
•     Psychological discomfort: mucositis after chemotherapy or radiation therapy lowers the quality of life of a patient who already has a serious illness.
•     Interruption of treatment: oral mucositis is the reason why the doctor may reduce the dose of radiation or chemotherapy or temporarily suspend treatment.

DIAGNOSIS OF MUCOSITIS

To make a diagnosis, the following procedures are performed:

•     Seeding of the material taken from the surface of the affected area. Thanks to this study, it is possible to identify the causative agent of inflammation and choose the optimal method of antibacterial therapy.
•     A biopsy of the tissues of the affected area is performed in the absence of positive dynamics after the prescribed standard treatment.
•     An endoscopy of the oral cavity is performed in case of suspected mucositis of the esophagus or stomach.

TREATMENT OF MUCOSITIS

For the treatment of mucositis, the oral cavity is treated with anti-inflammatory compounds or special gels that have antibacterial, antifungal and mucosal regenerating properties. The treatment products include a mucous membrane protector based on hyaluronic acid VITA-HYAL, which reduces inflammation, restores the surface protective layer and provides moisture to the oral mucosa. Also VITA-HYAL contains comenic acid – innovative stimulator of mucous regeneration.

VITA-HYAL has 3 forms of release:

- Mouthwash

- Gel

- Spray (convenient to take with you to work or travel)

PREVENTION OF MUCOSITIS

Prevention of mucositis includes several important aspects:

•     Basic oral care.
•     Giving up bad habits.
•     10-12 days before the planned radiation or chemotherapy, carry out preventive sanitation of the oral cavity: carry out preventive procedures, if there are any diseases, then cure them.