Evaluation of the severity of oral mucositis
The specific elements that have to be taken into account when
examining the mouth are:14
- A change in color
- Hyposalivation
- A change in the integrity of the mucosa
- The presence of edema on the lips and/or the tongue
- Oral hygiene problems
There are many classification systems, some more complex than
others, for evaluating the severity of oral mucositis. Those most
commonly used in clinical practice are the WHO scale (World Health
Organisation) and the American NCI Scale (National Cancer Institute
- Common Toxicity Criteria, or NCI-CTC).
According to the WHO classification, oral mucositis consists of
four "Grades", ranging from the most benign to the most severe.
Grades 1 and 2 are characterized by the presence of moderate pain
and the start of ulceration. Grades 3 and 4 are characterized by
severe oral mucositis. In Grade 3, patients can no longer tolerate
solid food and therefore have to take only a liquid diet. In Grade
4, it becomes impossible for the patient to feed himself and
feeding by a stomach tube may prove to be necessary.
