Dodd, M.J., Dibble, S.L., Miaskowski, C., MacPhail, L., Greenspan, D., Paul, S.M., et al. (2000). Randomized clinical trial of the effectiveness of 3 commonly used mouthwashes to treat chemotherapy-induced mucositis. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 90(1), 39–47.

Study Purpose

Test the effectiveness of three mouthwashes used to treat chemo-induced OM. Compared: salt/soda, (1 t each/pint of water) chlorhexidine and magic mouthwash (lidocaine, benadryl Maalox).
 

Intervention Characteristics/Basic Study Process

Also used the Pro-Self program for all patients. Nurses presented the Pro-Self Mouth Aware program to patients and provided them with mouthwash. This program incorporates good oral hygiene, new toothbrush, daily flossing, regular oral assessments, and instruction of oral conditions that the patient must bring attention to the nurse.

Oral assessment and oral protocol 4x/day. Swished MW for 20 sec and then discard. The MW bottles were collected after their sx subsided or after 12 days supply. Measured amount remaining in bottles.
 

Sample Characteristics

The mean age was 59.05 years.  
Chemo- not RT to head and neck or leukemia
 

Setting

23 outpatient/office settings, 202 patients (142 final pts)

Study Design

Randomized, double-blind trial to 1 of 3 mouthwashes.

Measurement Instruments/Methods

  • Oral assessment done when patient entered study. Oral assessment guide was taught to all patients by nurses.
  • Patient reports QOD via phone to nurse.
  • Use chi-square test, one-way analysis of variance
     

Results

Forty-seven patients dropped out, 11 took > 12 days to report a cessation of s/s.
No significance in three groups of demographics, disease-related variables. No significant difference in the time to reported cessation of the signs and symptoms from chemo-induced mucositis among the three groups (p = 0.59).
The average pain scores did not differ significantly (p = 0.79).
 

Limitations

Patient reports, no clinician assessment during mucositis

Limitation of OAG tool – this guide addresses information of oral cavity changes and not strictly mucositis

Structure of oral care program may have been the greatest effect on mucositis.
 

Nursing Implications

Findings support use of NS/baking soda over chlorhexidine and magic mouthwash – especially with established oral care program.