Eghbali, A., Taherkhanchi, B., Bagheri, B., & Sadeghi Sedeh, B. (2016). Effect of chewing gum on oral mucositis in children undergoing chemotherapy: A randomized controlled study. Iranian Journal of Pediatric Hematology and Oncology, 6(1), 9–14.

Study Purpose

To study the effects of salivary stimulation using chewing gum on oral mucositis (OM) in children undergoing chemotherapy

Intervention Characteristics/Basic Study Process

Patients were randomized to a control group or experimental group. Control patients were given a mouth rinse of nystatin, diphenhydramine, and aluminum three times per day. The test group received the same mouth rinse plus sugar-free chewing gum six times per day for 15 days. The gum was chewed for about 30 minutes.

Sample Characteristics

  • N = 130   
  • MEAN AGE = 8.5 years
  • MALES: 50.8%, FEMALES: 49.2%
  • CURRENT TREATMENT: Chemotherapy
  • KEY DISEASE CHARACTERISTICS: Most had hematologic malignancies.

Setting

  • SITE: Single site   
  • SETTING TYPE: Not specified    
  • LOCATION: Iran

Phase of Care and Clinical Applications

  • PHASE OF CARE: Active antitumor treatment
  • APPLICATIONS: Pediatrics

Study Design

  • Randomized, controlled trial

Measurement Instruments/Methods

  • World Health Organization (WHO) grading system for OM

Results

Prevalence of grade 1 (p < 0.05) and grade 2 (not significant) OM was lower in children who chewed the gum. Grade 3 mucositis was slightly higher among those chewing gum. No difference existed between groups in prevalence of grade 4 mucositis.

Conclusions

Chewing gum for salivary stimulation may help reduce inflammation with low grades of mucositis but shows no overall benefit for more severe mucositis.

Limitations

  • Baseline sample/group differences of import
  • Unintended interventions or applicable interventions not described that would influence results
  • Chemotherapeutic agents used were not described. Adherence to interventions for mouth rinses as well as use of chewing gum are not described.

Nursing Implications

Chewing sugar-free gum to increase salivary stimulation is a low-risk intervention that may help in low-grade mucositis cases but appears to have no overall efficacy in reducing the prevalence or severity of mucositis in children receiving chemotherapy. Further research regarding the potential role of salivary stimulation for the prevention or management of OM would be beneficial.