Flurbiprofen Tooth Patch

Flurbiprofen Tooth Patch

PEP Topic 

Flurbiprofen is a type of nonsteroidal antiinflammatory drug. It is a cyclooxygenase 2 (Cox 2) inhibitor. Cox 2 has been associated with the development of mucositis and flubiprofen in the form of a tooth patch and has been evaluated for the prevention and management of mucositis in patients with cancer.

Effectiveness Not Established

Research Evidence Summaries

Stokman, M.A., Spijkervet, F.K., Burlage, F.R., & Roodenburg, J.L. (2005). Clinical effects of flurbiprofen tooth patch on radiation-induced oral mucositis. A pilot study. Supportive Care in Cancer, 13, 42–48.

doi: 10.1007/s00520-004-0674-6

Intervention Characteristics/Basic Study Process:

Tooth patches containing 15 mg flurbiprofen or placebo were applied once a day before sleep to the same natural tooth or the upper denture to the buccal side starting one week prior to radiotherapy (RT) until completion of RT. Treatment was discontinued at the first onset of grade 1 ulceration/pseudomembrane formation.

Sample Characteristics:

  • The sample consisted of 22 patients, 12 in the treatment group and 10 historical controls.
  • The median age was 57.7 – 59.2 years.
  • Patients had head and neck cancer and were being treated with RT.

Measurement Instruments/Methods:

Oral Mucositis Assessment Scale (OMAS) and World Health Organization (WHO) scoring systems were used to evaluate mucositis. Oral pain, pain on swallowing, global assessment of eating function score, and oral washings for viability of mucosal epithelial cells and maturation were used.


  • No difference was found in severity and duration of pseudomembranous mucositis.
  • None of the patients applied the patch for the whole RT course because of development of mucositis.
  • The treatment group experienced a later onset (p < 0.05).
  • Based on the OMAS, development and degree of mucositis were lower during the first two weeks. This difference was statistically significant (p = 0.007). After three weeks, the difference was not significant. Results according to the WHO scale was similar with all patients scoring at least 2.
  • The study showed a slight delay in the development of mucositis with the treatment; however, it was not effective in terms of prevention.
  • Pain was significantly higher in the flurbiprofen group only after the second RT week (p = 0.03).


  • The study size was small.
  • Use of historical control administration may have been too minimal to see effects.