Chemotherapy and other immunosuppressive treatments, while medically necessary and life-saving for many people, can cause some incredibly harsh side effects. Oral mucositis is one of them.
Oral mucositis can be a difficult condition to treat, significantly affecting a person’s quality of life. We know that light therapy can help with oral problems like canker sores and cold sores, but can it help with oral mucositis?
Existing research covers two aspects of light therapy for oral mucositis: prevention and treatment. Here we explore the available science.
What Is Oral Mucositis?
Oral mucositis is the irritation, swelling, and ulceration of the oral mucosa — the delicate tissues that line the mouth. It most often occurs in patients with compromised immune systems, especially from cancer treatments like chemotherapy and radiation.
Other conditions that lead to compromised immune systems can also cause oral mucositis, such as diabetes, lupus, and HIV/AIDS. Organ transplant patients may experience oral mucositis as a result of anti-rejection medications, which inhibit the immune system.
Poor oral hygiene, excessive alcohol intake, severe dehydration, and smoking or chewing tobacco can all contribute to oral mucositis as well.
Signs and symptoms of oral mucositis vary from person to person, but can include:
- Blood in the mouth (from open wounds)
- Difficulty swallowing
- Difficulty talking
- Dryness in the mouth
- Infection in the mouth
- Pain in the mouth
- Poor nutrition from lack of eating due to pain
- Shiny, swollen gums
- Thicker-than-normal saliva
- Ulcers on the tongue and gums
- White patches and pus in the mouth
Treatments for Oral Mucositis
If drinking, smoking, or dehydration are the source of a person’s oral mucositis, then altering those behaviors should help reverse the condition. Maintaining a good oral hygiene routine by gently brushing twice per day and flossing can help both prevent and reduce the degree of oral mucositis.
For cancer patients, oral mucositis usually resolves when treatments stop. In the meantime, however, treatments focus on pain reduction, nutritional support, and infection prevention. These can include:
- Saline rinses
- Numbing agents like ice chips or anesthetic rinses
- Pain medications, including opioids in more severe cases
- Soft diet
- Liquid nutritional supplements
- Diligent oral hygiene care
- Avoiding harsh oral care products like whiteners or alcohol-based mouthwashes
- Baking soda and water rinse
- Artificial saliva products
What Is Light Therapy?
Light therapy, also known as phototherapy or photobiomodulation, employs specific wavelengths of light to produce a variety of beneficial effects in the body. While light may not seem like it could have much effect, our cells actually absorb certain wavelengths of light and use them to produce adenosine triphosphate (ATP), the body’s energy source.
This energy production stimulates healing, repair, and tissue rebuilding from a cellular level. As such, light therapy can successfully treat a wide variety of skin conditions and other ailments. While it’s not a magic bullet, light therapy does have some incredible applications backed by scientific research.
Can Light Therapy Help With Oral Mucositis?
Research is in its early stages for oral mucositis and light therapy, but results do look promising.
The Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) recently updated their guidelines to recommend light therapy for preventing oral mucositis in many more patients, citing stronger evidence for its efficacy and safety.
Researchers at St. Jude’s Children’s Research Hospital wishing to prevent oral mucositis in children receiving bone marrow transplants developed a study using light therapy. Using a handheld, lollipop-like device, clinicians administered daily low-level light therapy (LLLT) for one minute inside and outside the mouths of children enlisted in the study. Each child received treatment until the day of their bone marrow transplant or for 20 days.
Results are forthcoming, but evidence so far suggests the light therapy effectively prevents severe oral mucositis without side effects. They note also that patients who complain of oral pain, even if no cause is yet visible, find relief from the therapy.
Many researchers and clinicians are hopeful about the use of light therapy in treating existing oral mucositis and agree that more studies in this area are needed.
A 2020 research article concluded that evidence is growing for the use of light therapy in improving the quality of life of oral cancer patients by minimizing treatment side effects. The authors express concern, however, regarding the lack of evidence on the potential impact of light therapy on head and neck tumors. They encourage further study to determine whether light therapy is safe in the vicinity of cancerous tumors and the best methods of application.
A literature review published in BioMed Central Oral Health combed through light therapy research for oral mucositis conducted between 2000 and 2019. They, too, concluded that more research is needed.
Both studies expressed concern over the potential for light therapy to encourage cancer cell proliferation or mutation. They also noted the difficulty in isolating one particular type of light therapy due to the wide variety of wavelengths, power levels, and application types used in the studies.
What Kinds of Devices Are Available for Oral Mucositis?
Unfortunately, there are no products on the market designed specifically for oral mucositis at this time. There are several products designed to treat canker sores, but you should speak to a physician before experimenting with light therapy for oral mucositis, especially considering the concerns regarding its possible effects on tumors.