Oral mucositis occurs as a complication of cytotoxic chemotherapy and radiotherapy given to ablate the bone marrow prior to bone marrow transplantation. Walsh et al developed a scoring system to help quantitate the severity of the mucositis. The authors are from the University of Queensland in Australia.
Parameters used for score:
(1) voice
(2) ability to swallow
(3) lips
(4) tongue
(5) buccal mucosa
(6) hard and soft palate
(7) gingiva
(8) teeth
(9) saliva production
(10) patient's self-assessment
Parameter |
Finding |
Points |
---|---|---|
voice |
normal |
0 |
|
deep or raspy voice |
1 |
|
discomfort or pain on talking |
2 |
swallow |
normal |
0 |
|
slight difficult or pain |
1 |
|
unable to swallow |
2 |
lips |
normal (smooth and pink) |
0 |
|
dry or cracked |
1 |
|
blistered, cracked |
2 |
tongue |
pink, moist, with papillae present |
0 |
|
coated, with loss of papillae |
1 |
|
blistered, cracked |
2 |
buccal mucosa |
pink and moist |
0 |
|
reddened or coated; no ulcers |
1 |
|
ulcerations with/without bleeding |
2 |
hard and soft palate |
pink and moist |
0 |
|
reddened or coated; no ulcers |
1 |
|
ulcerations with/without bleeding |
2 |
gingivitis |
pink and stippled |
0 |
|
edematous and painful |
1 |
|
reddened, swollen, bleeding |
2 |
teeth |
clean, no debris |
0 |
|
plaque or debris localized |
1 |
|
generalized debris along gingiva |
2 |
saliva production |
moist mouth |
0 |
|
dry mouth but saliva present |
1 |
|
very dry mouth, parched, coated |
2 |
patient self-assessment |
no discomfort |
0 |
|
mild discomfort |
1 |
|
moderate pain |
2 |
|
severe pain |
3 |
oral mucositis score =
= SUM(points for all 10 parameters)
Interpretation:
• minimum score: 0
• maximum score: 21
• The higher the score, the more severe the mucositis.
• Based on the severity of the oral mucositis, different oral hygiene regimens were used, with greater care given as the severity of the mucositis increased.
Score |
Grade of Mucositis |
---|---|
0 |
none |
1 – 7 |
mild |
8 – 14 |
moderate |
15 – 21 |
severe |
Purpose: To use the scoring system of Walsh et al to evaluation a patient with oral mucositis associated with bone marrow transplantation.
Specialty: Hematology Oncology, Surgery, general, Otolaryngology
Objective: severity, prognosis, stage, adverse effects, prevention
ICD-10: K12.3, Y43.4,