Oral Mucositis (Stomatitis): An acute inflammation and/or ulceration of the oral or oropharyngeal mucosal membranes. It ORAL MUCOSITIS GRADING SCALE Adapted NCI CTCAE (Version 4.03) GRADE 1 (Mild) GRADE 2 (Moderate) GRADE 3 (Severe) GRADE 4 (Life - threatening) GRADE 5 Asymptomatic or mil Nathaniel S. Treister, DMD, DMSc describes the differences between the WHO and the NCI grading scales Mucositis grading scales NCI-CTC: The National Cancer Institute created originally the Common Toxicity Criteria (CTC) to aid in the recognition and grading severity of adverse effects caused by chemotherapy treatments. NCI-CTCAE Grading Scale* Grade: Description: Grade 0 (none) None A wide variety of scales have been used to record the extent and severity of oral mucositis in clinical practice and research. The World Health Organization (WHO) scale is a simple, easy to use scale that is suitable for daily use in clinical practice. This scale combines both subjective and objective measures of oral mucositis (Table 1) Tardieu mucositis scale Ranges from grades 0 to 3. Grades 2 and 3 on the Tardieu scale are similar to grades 3 and 4 according to the other mucositis grading scales. Late effects of normal tissues/subjective objective management analytic scale (LENT/SOMA) Grade Description 1 Normal moisture 2 Scant moistur
Visual Analog Scale Score Oral Mucositis Radiation Therapy Oncology Group None None National Cancer Institute Common Toxicity These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves Background The ability to consistently and accurately assess oral mucositis (OM) is critical to descriptions of its incidence and severity and in evaluating the effectiveness of potential interventions. The lack of a single grading scale compounds outcome interpretation. Consequently, we assessed the concordance of three of the most commonly used OM grading criteria (World Health Organization. Although several grading scales exist for the severity of OM, the most commonly used include the World Health Organization (WHO) Oral Toxicity Scale and the National Cancer Institute Common.. The Oral Mucosa Rating Scale (OMRS) has an examination rating scale to quantify the type and severity of clinically evident oral mucosal changes (atrophy, erythema, ulceration, and pseudomembranous, hyperkeratotic, lichenoid, and edematous changes), with a scale ranging from 0 to 3 (normal to severe)
WHO Oral Mucositis Grading Scale The presence of oral mucositis is assessed based on clinical manifestations. The score ranges from 0 (the absence of manifestations and symptoms) to 4 (oral feeding is impossible). of oral mucositis typically occurs and the lesions are most severe. Conclusions: Oral mucositis in patients who have undergone bone marrow transplanta-tion can be quantified reliably with the easily administered PROMS scale. The PROMS scale provides a valid measure of the impact of oral mucositis on the oral-health-relate Oral mucositis also affects up to 80% of patients receiving radiation for head and neck malignancies (WHO) grading scale, the oral assessment guide (OAG), the cancer and leukemia group B (CALGB) assessment guide and others listed in Table 2. These numerous assessment tools have a variety of strengths and weaknesses The National Cancer Institute Common Toxicity Criteria (NCI-CTC) scale closely resembles the WHO scale by incorporating nutritional criteria as well. Two other scales commonly used to grade oral mucositis are the Radiation Therapy Oncology Group (RTOG) scale and the Oral Mucositis Assessment Scale (OMAS) Oral mucositis is a common, dose limiting and potentially serious complication of both radiation and chemotherapy. Both these therapies are non-specific, interfering with the cellular homeostasis of both malignant and normal host cells. An important effect is the loss of the rapidly proliferating ep
• Maintaining oral health throughout the treatment phase is necessary to: - maintain adequate hydration and nutrition - reduce the incidence, severity and duration of oral mucositis - prevent or minimize the effects of oral complications • A dental exam and any interventions should be performed by a dentist (or oral oncolog Oral mucositis is an unseen, but damaging side effect of cancer treatment more commonly known as cancer mouth sores or chemo mouth sores. Here we cover related complications, costs, the oral mucositis grade scale, and cancer mouth sores products, solutions, and treatments Definition Oral mucositis. Erythematous and/or ulcerative lesions of the mucosal lining of the oral cavity secondary to anti-cancer agents, radiation therapy, particularly to the head, neck or oesophagus, or high dose chemotherapy followed by blood and marrow transplant (BMT). r. Stomatitis. Any inflammatory condition of the oral tissues.Stomatitis can include oral ulceration, xerostomia.
WHO Oral Mucositis Grading Scale Grade Description 0 (none) None I (mild) Oral soreness, erythema II (moderate) Oral erythema, ulcers, solid diet Oral mucositis is a significant toxicity of systemic chemother-apy and radiotherapy to the head and neck. The morbidity or oral mucositis, includes pain, nutritional compromise,. reliable grading scale designed for chemotherapy-induced oral mucositis will allow oncology nurses to recognize and monitor the progression of oral mucositis. Reliable oral mucositis rating scales, when employed routine-ly, will facilitate the use of appropriate nursing interventions for patients with oral mucositis and, ultimately, improve pa. Preventing Severity of Oral Mucositis for the Adult Receiving In-patient Chemotherapy Jessica Johnson RN, OCN University of Missouri Health Care Background Purpose Mucositis Grading Scale Results Plan for Intervention References Thirty to seventy-five percent of patients receiving chemotherapy experience oral mucositis (Cawley & Benson, 2005) The grading of oral mucositis lesions is based on physical findings such as erythema and presence of ulcers as well as the nutritional abilities of the patient. Whether the patient can tolerate solid foods or liquids only, or neither, contributes to the grade of mucositis. The World Health Organization (WHO) grading scale for oral mucositis i
A wide variety of scales have been used in clinical practice and research to record the extent and severity of oral mucositis [45,46].The World Health Organization (WHO) Oral Toxicity Scale and the National Cancer Institute-Common Toxicity Criteria for Adverse Events (NCI-CTCAE) system are two most commonly used scales ().The WHO Oral Toxicity Scale is a simple and easy-to-use tool that is. Mucositis is an inflammatory process that affects the mucous membranes of the oral cavity and gastrointestinal tract. ONS PEP resources focus on oral mucositis, which is estimated to occur in about 40% of patients secondary to chemotherapy and almost 100% of those receiving radiation for head and neck cancer. Approximately 80% of those undergoing hematopoietic stem cell transplantation will.
The PROMS scale is a valid measure of the impact of oral mucositis on the oral-health-related quality of life of these patients and is a potentially useful measure for patients with other types of cancer who are subject to this malady. The PROMS scale could be used in future studies to assess the effectiveness of new treatments for oral. WHO ORAL MUCOSITIS SCALE Grade 0 - No objective findings, function irrelevant Grade 1 - Erythema plus pain, function irrelevant - May include mucosal scalloping with or without erythema or soreness Grade 2 - Ulceration, ability to eat solids Grade 3 - Ulceration, ability to eat liquids Grade 4 - Ulceration, nothing by mouth. The WBS showed results superimposed on the WHO oral mucositis grading scale in choosing the intensity and duration of mucositis treatment.ConclusionOral mucositis is a common complication of chemotherapy against childhood malignancies. The WHO oral mucositis scale is a valuable tool for assessing its severity in pediatric patients
Organization (WHO) scale for oral mucositis (OM) evalu-ation accounts for objective criteria, such as the presence of either erythema or ulceration. These are functional criteria based on the ability of the patient to eat. A quantitative scale that assesses ulceration dimension is used by the Oral Mucositis Assessment Scales (OMAS). Th . It is one of the most commonly used outcome measures in. Sites of Mucositis While the oral mucosa is the most frequent site of mucosal toxicity, mucositis also is common along the entire alimentary tract: Esophagus - duodenum - colon Stomach - ileum/jejunum - rectum GI mucositis occurs via a mechanism similar to that in the oral mucosa, only the damage to the mucosal layer is more aggressive. Two other scales commonly used to grade oral mucositis are the Radiation Therapy Oncology Group (RTOG) scale and the Oral Mucositis Assessment Scale (OMAS). These scales do not use nutritional criteria for grading oral mucositis. Table 1 shows the different grading scales for oral mucositis. The ability of the patient to tolerate oral intake of. WHO's Oral Toxicity Scale World Health Organization's Oral Toxicity Scale Severe Mucositis Grade 1 Grade 2 Grade 3 Grade 4 Ulcers with Mucositis Erythema, extensive to the extent ulcers; Soreness erythema; that patient can ± erythema patient alimentation swallow cannot is not solid food swallow food possibl
The Cost of Oral Mucositis Caused by Chemo. The appearance of chemo mouth sores is more than a painful inconvenience, as it can easily grow to become a costly, life-threatening condition, especially if oral care is neglected. This is especially true in the more severe cases of oral mucositis - those on the higher end of the grading scale When oral mucositis WHO grading and the OMAS scale were compared from day one to the last day of treatment it was noticed that there was a significant rise in the severity and incidence of oral mucositis grading, starting from day 5. A severe type of oral mucositis was developed by the end of treatment, whereas in the middle of the treatment. Patients having clinical signs of chemotherapy-induced or radiotherapy-induced OM (WHO oral mucositis grading scale: Grade II, III and IV) Patients over the age of 18 years; Patients having no history of allergy, allergic rhinitis and asthma; B- Exclusion criteria: Patients allergic to the used treatment; Patient receiving systemic steroid
Assess level of mucositis, using the WHO oral toxicity scale & Table 1. Recommended Mucositis Intervention as a guide. o. Ongoing assessment of current treatment and alter accordingly. 4 Management 1,2,3,5 • Oral paracetamol or oxycodone can be used in the early stages where intake of the solution is still tolerated, but rectal preparations. It can be hard to manage mucositis and to determine how bad a case is because each person is different. The World Health Organization (WHO) oral toxicity scale is one of a number of grading systems that is used to stage the severity of mucositis WHO Scale for Oral Mucositis. NCI CTCAE version 4.03. Grade 0 (none): No oral mucositis. Grade 1: Asymptomatic or mild symptoms/ intervention not indicated. Grade 1 (mild): Erythema and soreness grading of oral mucositis and WHO scale for oral mucositis Grade 0 Normal mucosa, no symptoms Grade 1 Asymptomatic/mild symptoms: erythema of the mucosa, normal diet: Intervention not required Grade 2 Moderate pain, not interfering with oral intake: patchy ulcerations Modified diet not indicated
demonstrating Grade 3 or Grade 4 mucositis as de-ﬁned by the WHO scale of the NCI's Common Toxicity Index (CTI) and have been inpatients during the che-motherapy treatment period. Patients receiving radi-ation therapy were required to have been scheduled t Mucositis was evaluated according to the Oral Toxicity Scale of the World Health Organization (WHO), 5 which is based on objective (redness or erythema, ulcer development) and subjective signs (ability to swallow, sensitivity of the mucosa) and classifies mucosa into four grades: Grade 0, no change observed in oral cavity during treatment. - With grade 3 or 4 oral mucositis: 35% require dose delays 60% require dose reduction 30% have cessation of chemotherapy - With standard dose chemo and grade 3 or 4 oral mucositis: 60% have fever and 62% require hospitalization - With high dose chemo and grade 3 or 4 oral mucositis: 80% requiring opioid analgesics • COST: $5,565/cycl oral mucositis Grade 1 (according to mucositis grading scale) and two developed mucositis Grade 2; candida infection was not detected among patients . This result indicates propolis can reduce oral mucositis symptoms and prevent lesions occurrence
Currently, there are different scales to grade mucositis, whose parameters vary among them. The World Health Organization (WHO) scale for oral mucositis (OM) evaluation accounts for objective criteria, such as the presence of either erythema or ulceration. These are functional criteria based on the ability of the patient to eat List of Table. Table 1: Summary of Oral Mucositis, Market, Epidemiology, and Key Events (2018-2030) Table 2: Differential diagnosis of Oral Mucositis Table 3: WHO oral mucositis scale/common toxicity criteria Table 4: National Cancer Institute Common Terminology Crieria (NCI CTC) Grading of the severity of adverse events secondary to chemotherapy and radiotherapy toxicity NCI CTCAE (version 3 and 4) uses a grading scale which ranges from 1 to 5; for our purpose, severe mucositis was considered grades 3 to 5 , . We also included the Tardieu mucositis scale which ranges from grades 0 to 3 . Grades 2 and 3 on the Tardieu scale are similar to grades 3 and 4 according to the other mucositis grading scales and.
Severe oral mucositis is defined as a Grade 3 or above score on the World Health Organization's Oral Mucositis Grading Scale. WHO's Scale for OM goes from Grade 0 (none) to Grade 4 (ulceration. The diagnosis of mucositis is generally based on clinical findings. After a diagnosis has been made, two main grading scales are used by clinicians to assess severity: the World Health Organization's (WHO) Oral Toxicity Scale and the National Cancer Institute's (NCI) Common Toxicity Criteria (TABLE 1). 6,
World Health Organization and patient-based oral mucositis scales were used for evaluation. Results: According to the WHO based Oral Mucositis Scale, the incidence of oral mucositis in the intervention group (45%) was significantly lower than the control group (77.5%; P=0.01). The incidence of oral mucositis in the intervention group based o The occurrence of ulcerative lesions and severity of mucositis was measured at baseline and twice weekly (Days 0,3,6,9,12,15 of each study period), using the Oral Mucositis Assessment Scale and World Health Organization Grading Scale (Table 1). Those who developed oral mucositis were monitored every 3 days until lesions completely healed Before enrollment, each patient had an oral examination by an enrolling clinician that confirmed the presence of oral mucositis and the absence of oral infection using the Oral Mucositis Assessment Scale 16 and the WHO mucositis grading scale. 17 Eligible patients were also required to have mouth pain rated ≥ 4 on a numerical analog.
Overall reduction was seen at week 6 and the mucositis grade was found to be clinically significant as it reduces to grade 2 (34.6%) in group A and to grade 1 (43.9%) in group B, whereas association between grades of oral mucositis and intervention was statistically insignificant at week 6(p value 0.144) This is a case report of oral mucositis in Non-Hodgkin's Lymphoma (NHL) reported after 11 th fraction of radiotherapy. Chief complaints were ulceration of mouth with painful swallowing. Clinical diagnosis as per the World Health Organization Grading Scale was Grade 3 oral mucositis the Tardieu mucositis scale which ranges from grades 0 to 3 . Grades 2 and 3 on the Tardieu scale are similar to grades 3 and 4 according to the other mucositis grading scales and consequently, we classified Tardieu scale scores of grade 2 and 3 as severe mucositis. However, we conducted a sensitivity analysis excludin The primary effectiveness endpoint of the study is the proportion of patients who have severe oral mucositis (Grade 3 or 4) at week 6 of treatment according to the World Health Organization (WHO) Oral Toxicity Scale. Secondary Outcome Measures. Oral Mucositis Grade and Incidence over 6 to 8 weeks, evaluated once per wee A mouthwash appropriate to the grade of mucositis (see Appendix 3) should be prescribed. Appropriate pain control is recommended together with the continuation of good oral hygiene, as tolerated. The patient's pain should be assessed using the assessment tool in Appendix 3
. Chemotherapy-induced oral Mucositis (COM) is a frequent complication due to mucotoxic drugs and is known to deteriorate the general health significantly, while negatively affecting the quality of life (QOL) Oral Mucositis Background Mucositis is a common complication of cytotoxic chemotherapy. The incidence of mucositis in patients receiving cytotoxic chemotherapy for solid tumors is estimated at 5% to 40%. 1 The terms mucositis and stomatitis have been used interchangeably in medical and nursing literature but are not synonymous. Mucositis refers to the inflammatory process involving the mucous.
Comparison of oral mucositis assessment scales.7,58. The Oral Mucositis Index (OMI) considers the severity of OM in terms of erythema, ulceration, atrophy and edema , each graded on a scale from 0 to 3 (0=none, 3=severe) Basic description. Stiff PJ, Emmanouilides C, Bensinger WI, Gentile T, Blazar B, Shea TC, Lu J, Isitt J, Cesano A, Spielberger R. Palifermin reduces patient-reported mouth and throat soreness and improves patient functioning in the hematopoietic stem-cell transplantation setting. J Clin Oncol. 2006 Nov 20;24 (33):5186-93 ( Full text article Oral Mucositis Grading Scale and if this scale is helpful for nurses´work. Klíþová slova v J: hodnocení, škála, WHO, všeobecná sestra, ošetřovatelská péþe, mukozitida, dutina ústní, onkologický pacient Klíþová slova v AJ: assessment, scale, WHO, nursing, nursing care, mukositis, oral cavity, oncology patient The Oral Mucositis Assessment Scale (OMAS) is an objective scale, suitable for research purposes, that measures erythema and ulceration at nine different sites in the oral cavity 5. Table 3 Oral Mucositis Assessment Scale (OMAS) Location Ulceration Erythema Lip (upper & lower) 0, 1, 2, or 3 0, 1, or Grade 4: Ulceration, hemorrhage or necrosis. Grade 5: Death resulting from mucositis. Causes Both patient-related factors and treatment-related factors influence the severity of mucositis. Increased total dose of radiation, fraction size, and volume of normal tissue in the irradiated field all increase the risk of mucositis
Organisation (WHO) Scale Gradings • Regular assessment of oral mucous membranes is recommended. The use of an oral assessment tool provides a common language and base for comparison for ongoing physical assessment and evaluation of interventions • An example of an assessment tool is the World Health Organisation grading of oral mucositis Also, the Oral Mucositis Assessment Scale, and a Visual Analog Pain Scale (patient reporting scale of 0-10) are used for grading of mucositis. Mucosal changes like redness, ulceration with functional outcomes such as inability to eat and pain have been assessed in these scales. Based on clinical examination, 4 distinct grades can be determined.
. Benzydamine (15 mL of oral rinse 0. 15%) is used as a mouth rinse. It should be held in the mouth for at least 30 s, followed by expulsion (should not be swallowed), up to every 1-2 h Grade 5: Death. Appendix B Oral mucositis grading according to World Health Organization recommendations (adapted from reference 27) Grade 0: None. Grade 1: Oral soreness, erythema. Grade 2: Oral erythema, ulcers, solid diet tolerated. Grade 3: Oral ulcers, liquid diet only. Grade 4: Oral alimentation impossibl Figure 1. Incidence of Oral Mucositis by Maximum Grade in Study 1 Kepivance™ Placebo (n = 106) (n = 106) WHO Oral Mucositis Scale: Grade 1 = soreness/erythema; Grade 2 = erythema, ulcers, can eat solids; Grade 3 = ulcers, requires liquid diet only; Grade 4 = alimentation not possible
Oral mucositis was assessed with the use of three scales: the five-grade World Health Organization (WHO) oral-toxicity scale 17 (primary scale), the five-grade Radiation Therapy Oncology Group. The proper use of assessment scales, nonpharmacologic methods such as good oral hygiene and cryotherapy, and pharmacologic treatment are important for the prevention or management of OM. Oral mucositis (OM) is one of the most common adverse effects encountered during chemotherapy (CT) and radiotherapy (RT) in patients with head-and-neck cancer.
Oral mucositis was assessed using a quantitative scale and symptoms were assessed using visual analogue scales. The statistical model was developed to detect a 40% reduction in mucositis. No statistically significant reduction in mucositis was seen The WHO scale description of Mucositis manifestation is as erythema (Grade 1), edema and/or ulceration but patients can swallow solid food (Grade 2) to ulceration with extensive erythema and. oral rinse had a mean OM grade of 1 to 2 on the NCI OM toxicity grading scale, maintained their weight, and reduced their need for narcotics. Of the 26 patients who did not use the oral rinse as instructed, 13 of them developed grade 3 OM. Our results indicate that MuGard is a powerful tool for reducing OM incidence, significant weight loss, an
Denta Calculus Grading Scale Dental Dental Hygiene School. Periodontitis Staging And Grading Oral Health Group. Dental Indices. Michigan S Postsecondary Programs Of Study Grand Rapids Community. Frontiers Radiation Induced Oral Mucositis Oncology. 1581663316000000 One novel approach, the Oral Mucositis Assessment Scale (OMAS), also includes anatomic evaluation of the extent and severity of lesions. 6, 10 Due to lack of specificity, lack of patient input, difficulty of use with patients experiencing severe pain, and technical challenges in administration, 1 no single scale has emerged as a universal. 5.1.1. Signs and Symptoms of Oral Mucositis 5.1.2. Risk Factors and Causes of Oral Mucositis 5.1.3. Pathogenesis of Oral Mucositis 5.1.4. Course of Oral Mucositis 5.1.5. Genetics of Oral Mucositis.
Inflammation of the mouth and lips. Broader term that includes Oral Mucositis. Mucositis. Painful inflammation and ulceration of the gastrointestinal tract. Typically caused by Chemotherapy or Radiation Therapy. III. Causes: Stomatitis. Vitamin Deficiency (typically associated with recurrent Aphthous Ulcer s) Iron Deficiency Anemia The most widely used measurements for oral mucositis are the World Health Organization and Radiation Therapy Oncology Group (RTOG) scales. Also, the Oral Mucositis Assessment Scale, and a Visual Analog Pain Scale (patient reporting scale of 0-10) are used for grading of mucositis. Mucosal changes like redness, ulceration with functiona Oral mucositis is a debilitating complication of chemotherapy, characterized by erythema, ulcers and oedema of the oral mucosa. This review aimed to evaluate the efficacy of Photobiomodulation in the treatment of oral mucositis using meta-analysis and trial sequential analysis, and also to assess the quality of the results by Grading of Recommendations, Assessment, Development and Evaluation. Besides NCI and WHO grading scales, other scales included in the studies were Oral Mucositis Index, the Southwest Oncology Group Criteria, and Eastern Cooperative Oncology Group scale. To our knowledge, this is the first analysis on OM in allogeneic HSCT patients with respect to conditioning regimens, and we observed that RIC regimens led to a.
Oral mucositis is a painful and potentially dose-limiting adverse effect of cytotoxic chemotherapy and head and neck radiation therapy. 1 The condition occurs in approximately 20% to 40% of patients receiving conventional chemotherapy. Apart from the direct morbidity, oral mucositis can limit oral intake and provide a site for local infection and a portal of entry for systemic infection Methods: Our study enrolled 15 patients who experience nasal mucositis after targeted therapy (Table). We designed a specific questionnaire according to Oral Mucositis Daily QuestionnaireOMDQ), Oral Mucositis Assessment Scale (OMAS), and the Patient-Reported Oral Mucositis Symptom (PROMS) to evaluate the change of life quality in NSCLC patients Erin Bartell BSN, CCRN, BMTCN. Oral mucositis is one of the most debilitating side effects of many anticancer therapies, and positive results from the use of low level laser therapy (LLLT) inspired a team of nurses at UPMC Shadyside in Pittsburgh to develop an intervention to help a group of colleagues not only learn how to deploy the laser treatment, but also to better assess mucositis and. . 11,12 The questionnaires were administered in the clinic before administration of the study intervention.
The severity of oral mucositis was evaluated with a scoring system released by the Radiation Therapy Oncology Group (RTOG), World Health Organization (WHO) or the Oral Mucositis Assessment Scale (OMAS) . Grade 3 or 4 is considered intolerable or severe according to the established scales . The incidence of weight maintenance and the incidence. Mucositis is one of the acute complications of radiotherapy which can ulcerate oral mucosa and cause severe pain and discomfort which can affect oral normal function. Propolis is a natural source of flavenoid which has antiulcer, antibacterial, antifungal, healing and anti-inflammatory effects. Using such an affordable compound without any bad smell or taste that has reasonable price can help. defined as grades 3 or 4 mucositis on a 5 point grading scale ranging from 0 to 4. Three instruments were graded in this Materials and Methods fashion, namely the World Health Organization (WHO) scale, the Data Sources and Searches Radiation Therapy Oncology Group (RTOG) scale, and the We developed a protocol for this review and followed the. Oral mucositis disrupts the function and integrity of the oral cavity, which, in turn, affects functional status and quality of life. It is associated with significant clinical morbidity, which may include pain, malnutrition, and local and systemic infections ( Eilers , 2004) Oral Mucositis In Cancer Care 1. Oral Mucositis in Cancer Care: Is The End in Sight? Peter B. Lockhart, DDS, FDS RCPS Chair, Department of Oral Medicine Carolinas Medical Cente
Oral mucositis (OM) is a complication in HNC patients undergoing RT. This study aimed to identify the incidence, distribution of OM, and its effect on treatment breaks in a section of HNC in patients in Iraq. Methods: This is an observational, descriptive cross-sectional study Nine studies used the grading scale for oral mucositis, whereas only one study used the NCI oral toxicity scale. One study used the visual analogue scale and compass. In view of the scarcity of articles related to the theme of this review, 10 studies were added which addressed the anti-inflammatory effects and lesions healing induced in.
Background: Oral mucositis is a complication of cancer therapy, causing severe pain that affects oral functioning, nutrition, and quality of life, as well as therapy nonadherence or dose-limiting toxicity. Anecdotal experience has suggested that methylene blue (MB) oral rinse may be an effective and safe treatment of this oral pain. Methods: To evaluate the efficacy and safety of MB oral rinse. List of Table. Table 1: Summary of Oral Mucositis, Epidemiology, and Key Events (2018-2030) Table 2: Differential diagnosis of Oral Mucositis Table 3: WHO oral mucositis scale/common toxicity criteria Table 4: National Cancer Institute Common Terminology Criteria (NCI CTC) Grading of the severity of adverse events secondary to chemotherapy and radiotherapy toxicity