Low-level laser therapy for preventing or treating oral mucositis caused by radiotherapy or chemotherapy

2.1 Oral mucositis (OM) is a common side effect of chemotherapy or radiotherapy used for treating head and neck cancer or before bone marrow transplantation. Symptoms usually start 5 to 10 days after chemotherapy or 14 days after radiotherapy and include dryness, halitosis, pain, inflammation and oral mucosa ulceration. Chemotherapy-associated OM can resolve within a few days after completion of chemotherapy, but radiotherapy-associated OM can last for weeks. OM can affect nutritional status (which may need enteral or parental nutrition) and quality of life, and can increase hospital stay. It can also require interruptions or dose reductions in chemotherapy or radiotherapy treatment.

2.2 Comprehensive oral hygiene, good hydration, a bland soft diet and avoiding alcohol and tobacco may increase the person's comfort. Ice, water-based moisturisers, painkillers and non-steroidal anti-inflammatory drugs can help reduce symptoms. Drugs such as palifermin are sometimes used to prevent or treat OM. Antibiotics may be needed to treat infectious complications.

2.3 Low-level laser therapy aims to treat or prevent OM by promoting healing, reducing inflammation and increasing cell metabolism. A hand-held probe is used to deliver light in the red or near-infrared spectrum to the oral mucosa. It can be delivered intra-orally or extra-orally, or as a combination of both approaches. During intra-oral treatment the probe, which is about the size of a dental curing light, is introduced into the mouth. For extra-oral treatment the probe is positioned close to the cheek. The procedure typically takes 20 to 30 minutes, and is delivered 2 to 5 times a week for the duration of the oncology treatment. The procedure may be started before treatment with chemotherapy or radiotherapy begins, with the intention of preventing OM.