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Low level light therapy in the management of paediatric oral and oropharyngeal mucositis Fiona McDowall Nora O'Murchu Richard Welbury Dental Update 2024 44:6, 707-709.
Authors
FionaMcDowall
BDS, MFDS
Specialist Registrar in Paediatric Dentistry, Leeds Dental Institute/North Yorkshire Community Dental Services, University of Central Lancashire, Preston PR1 2HE, UK
Specialist Registrar in Paediatric Dentistry, Glasgow Dental Hospital/Royal Hospital for Children, Glasgow, University of Central Lancashire, Preston PR1 2HE, UK
Oral and oropharyngeal mucositis is a common, debilitating condition experienced by patients undergoing oncology treatment. There are many different management strategies, with low level light therapy (LLLT) an emerging field. Ongoing research on the topic of LLLT for mucositis has resulted in LLLT being included in national clinical guidelines. The number of centres currently using LLLT for paediatric patients with oropharyngeal mucositis is growing, with Glasgow having successfully used this treatment method for a number of years. Across medicine and dentistry, LLLT is coming to the fore and is a treatment modality of which we should all be aware.
CPD/Clinical Relevance: New technologies and treatment modalities are areas with which practitioners should stay up to date. Low level light therapy continues to be a growing research field.
Article
Oral and oropharyngeal mucositis occurs in 52–80% of children undergoing treatment for cancer.1 Mucositis is a debilitating condition which can be so severe that it can delay or stop oncology treatment. The mucositis disease process is initiated by chemotherapy or radiotherapy at 0–2 days, followed by cell damage at 2–10 days. Frank ulceration and mucosal damage occurs at 10–15 days, finally healing after 2–3 weeks. The clinical presentation is a combination of erythema and ulceration; and as healing begins, mucosal sloughing affects the intra-oral tissues and oesophageal tract (Figure 1). Maintaining adequate oral hygiene is difficult due to oral discomfort which may further exacerbate the condition and increase a patient's vulnerability to developing infection. The consequences for paediatric patients are significant: eating, drinking, speaking and engaging with those around them can be significantly restricted. This presents concerns regarding recovery and physical and mental wellbeing. Psychological distress has been described by parents of children suffering from mucositis at a time when stress and anxiety of the parent and child is already amplified by many other factors.2
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