8
Treatment
Table 4. MASCC/ISOO Daily Oral Care Plan for Patients
Intervention Basic Oral Care Plan
Flossing • Floss at least once daily.
• Waxed floss may be easier to use and minimize trauma to the
gingivae.
• If flossing causes bleeding of the gums that does not stop after
2 minutes, consult your oncolog y team.
Brushing • Use a small, ultra soft-headed, rounded-end, bristle toothbrush
(an ultrasonic toothbrush may be acceptable).
• Use prescription strength fluoride toothpaste. Spit out the foam but
do not rinse mouth.
• Use remineralizing pastes and chewing gum containing calcium and
phosphate.
• Brush within 30 minutes after eating and before bed. Ensure the
gingival portion of the tooth and periodontal sulcus are included.
• Rinse toothbrush in hot water to soften the brush before using.
• Brush tongue gently from back to front.
• Rinse brush after use in hot water and allow to air dry.
• Change toothbrush when bristles are not standing up straight.
For patients
with dentures
• Remove dentures, plates and prostheses before brushing.
• Brush and rinse dentures after meals and at bedtime.
• Remove from mouth for long periods (at least 8 hours per 24 hours)
and soak in rinsing solution.
Rinsing • Rinsing the oral cavity vigorously helps maintain the moisture in the
mouth, removes the remaining debris, and reduces the accumulation
of plaque and infection.
• Patients should rinse, swish and spit with a bland rinse (1 teaspoon
salt, 1 teaspoon baking soda in 4 cups of water) several times a day.
• Club soda should be avoided, due to the presence of carbonic acids.
• Commercial mouthwashes with alcohol base or astringent
properties are not recommended for patients with oral
complications.
• Debriding should only be done if absolutely necessary, if tissue is
loose causing gagging or choking.
