Seto et al listed criteria for evaluation of oral mucositis and oral hygiene in a patient following bone marrow transplantation. The authors are from UCLA Center for the Health Sciences.
Oral mucositis was defined as any change in the mucosa of the oral cavity. Changes may include erythema, mucosal erosion, ulceration and/or sloughing.
Parameters:
(1) pain intensity
(2) oral mucositis
(3) oral debris (hygiene)
|
Pain Symptoms |
Pain Intensity |
|
no pain |
none |
|
manageable without analgesics |
mild |
|
manageable with nonnarcotic oral analgesics |
moderate |
|
requires parenteral narcotic analgesics, with or without relief |
severe |
where:
• Severe pain could be divided into severe and very severe, with the former responding to parenteral narcotics and the latter not responding.
|
Appearance |
Pain Intensity |
Grade of Mucositis |
|
normal |
none |
Grade 0 |
|
localized erythema |
none |
Grade I |
|
generalized erythema without ulceration |
none |
Grade II |
|
localized ulcers and/or localized erythema |
mild |
Grade II |
|
multiple ulcers and/or generalized erythema |
moderate |
Grade III |
|
generalized ulcers and/or generalized erythema |
moderate or severe |
Grade IV |
|
Observable Plaque or Debris on Hard and Soft Tissues |
Oral Hygiene Index |
|
< 10% |
excellent |
|
10 - 24.9% |
good |
|
25 - 75% |
fair |
|
> 75% |
poor |
Other factors impacting patient care:
(1) bleeding
(2) infection
(3) tooth decay
(4) xerostomia (associated with graft versus host disease)
Specialty: Hematology Oncology, Surgery, general, Otolaryngology
