Nursing management of acute oral complications of cancer.

This review evaluates the state of the science and art of nursing management of acute oral complications of cancer. Published general oral hygiene protocols are reviewed briefly, and modifications to routine nursing care for hemorrhage, infection, pain, and problems associated with radiation to the head and neck are explored. There is a scarcity of research on which to base recommendations. The literature is primarily anecdotal or based on reports of experience at a single institution. Inconsistencies among such reports are numerous and have a detrimental effect on nursing management, as various clinicians provide different patient care instruction. Known principles, e.g., the need for adequate plaque removal and infection control, form the basis for nursing guidelines. Research is needed to guide clinical decision making, especially in defining the use of toothbrush substitutes. Problems in pain management appear to arise from inadequate application of known pain management principles. Since many of the oral complications are interrelated, nursing management must also take an integrated approach, and nursing care research must be conducted in the context of multidisciplinary care. Careful transfer of current research-based knowledge to practice and future research will help to achieve high-quality nursing management of acute oral complications.