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Head and neck cancer is the 6th leading
cancer world wide.
 Oral Mucositis is one of the most frequent
complications seen in the treatment of
head and neck cancer.
 Oral mucositis develops in approximately
60-85% of patients undergoing radiation
therapy and chemotherapy.
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http://www.youtube.com/watch?v=1YX
eGXtujeE&sns=em
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Oral Mucositis is the inflammation and irritation
of the lining of the mouth.
This inflammation can evolve into ulcers
responsible for severe pain.
Mucositis can interfere with daily activities such
as eating, chewing, swallowing, and even
talking.
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Chemotherapy associated mucositis
typically peaks at 7 to 14 days, as
compared to radiotherapy associated
mucositis in head and neck cancer
patients, which peaks at weeks 4 to 6 of
treatment and usually lasts for weeks
after completion of radiation
Phase one is the initiation stage in which
radiation and chemotherapy directly
injures DNA and causes death of basil
epithelial cells.
 Phase two is when free radicals activate
messengers that send signals to the
inside of the cells which leads to tissue
injury and cell death.
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Phase three is the chain reaction of
amplifying and prolonging tissue injury
because the damaging events are
focuses on the sub mucosal and basil
epithelium, the clinical appearance of
the mucosal surface remains normal
 Phase four is the ulceration stage which
is the loss of mucosal integrity and
produces extremely painful lesions.
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 Phase
five is the healing process in
which proliferation of epithelium
occurs as well as cellular and tissue
differentiation, restoring the integrity of
the epithelium.
The low level laser has been evaluated for
the treatment and prevention of Mucositis.
 Low level laser therapy is the application of
red and near infrared light over injuries or
lesions to improve wound and soft tissue
healing, reduce inflammation and give
relief for both acute and chronic pain.
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The red and near infra-red light
commonly used in LLLT can be
produced by laser or high intensity LEDs.
 The intensity of LLLT lasers and LEDs is not
high like found in surgical lasers. There is
no heating effect.
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The low level laser is directed at affected
areas of the mouth and is thought to
stimulate healing therefore it helps to
reduce pain symptoms, helps improvement
of swallowing, and the quality of life of the
patients.
 After beaming the oral mucosa, pain relief
was noticed. Depending on the severity of
oral mucositis, on average, 2.5 treatments
per lesion in a period of one week were
sufficient to heal a mucositis lesion
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http://www.youtube.com/watch?v=9Mfr
rga40yw&sns=em
There are normally no adverse effects from
Low level laser therapy; however, patients
occasionally experience mild
discomfort/ache after treatment.
 This is due to a restimulation of the
inflammatory phase and should settle down
after 24-48 hours.
 All people present in the treatment area
should wear appropriate laser safety eye
wear, because the laser beam is harmful to
the eyes.
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The dental hygienist plays an important
role in meeting the unique and often
challenging oral health care needs of
patients who are impacted by cancer.
 Because cancer greatly affects the oral
tissues, the dental hygienist needs to
know about the potential side effects of
radiation and chemotherapy and how
to treat it.
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The average price range of the laser
itself is between $7,000-23,000
 Any dental professional can administer
this procedure after completing an 8
hour course.
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The low level laser has been proven to
significantly reduce and prevent the side
effects of oral mucositis caused by
chemotherapy and radiation.
 By using this laser we can improve the
patients quality of life by reducing
inflammation, ulceration, and pain in the
patients oral cavity.
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Antunes H, Herchenhorn C, & Aragugo E. (2011). Low Level Laser Therapy Reduces Oral
Mucositis in Head and Neck Cancer. N.P.
http://cancer.unm.edu/2011/08/18/lasertherapy-reduces-oral-mucositis-in-headand-neck-cancer/
Arbabi-Kalati, F., Arbabi-Kalati, F., & Moridi, T. (2013). Evaluation of the Effect of Low
Level
Laser on Prevention of Chemotherapy-Induced Mucositis. Acta Medica
Iranica, 51(3), 157-162.
Drs Rita G. E. C. Cauwels, & L. C. Martens. (2011). Low level laser therapy in oral
mucositis: a
pilot study. European Archives. Vol. 12.n.p. Retrieved from
http://link.springer.com/article/10.1007/BF03262791.Doi:10.1007/BF03262791
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Merigo, E., Fontana, M., Fornaini, C., Clini, F., Cella, L., Vescovi, P., & Oppici, A. (2012).
Preliminary study on radio-chemo-induced oral mucositis and low level laser
therapy.
AIP Conference Proceedings, 1486(1), 137-141. doi:10.1063/1.4757833
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http://www.thorlaser.com/