Effectiveness of sodium bicarbonate and zinc chloride mouthwashes in the treatment of oral mucositis and quality of life in patients with cancer under chemotherapy

Abstract

Aim:The purpose of the study is to evaluate the effectiveness of sodium bicarbonate and zinc chloride mouthwashes on oral mucositis and quality of life in patients undergoing chemotherapy. Design:The present study was a randomized controlled trial study.Methods: One hundred forty-four patients with a cancer diagnosis were randomly assigned into three groups: sodium bicarbonate mouthwash (n = 48), zinc chloride mouthwash (n = 48) and placebo group (n = 48). The severity of mucositis and quality of life were examined blindly at the baseline and 3-week follow-up. Results:The grade of oral mucositis decreased at the end of the third weeks in the sodium bicarbonate and zinc chloride groups rather than the placebo group (p < .001).The severity of oral mucositis in the sodium bicarbonate and zinc chloride groups decreased from end of the first week until third week (p < .001). In addition, there was significant difference in the severity of oral mucositis among the groups at the end of the second (p = .014) and the third weeks (p < .001). Also, there was a statistically | 1603 MOHAMMADI et Al.

Prevention and the treatment of oral mucositis: the efficacy of sodium bicarbonate vs other agents: a systematic review

“…Finally, Mohammadi et al evaluated 144 a total of 3 groups of patients undergoing chemotherapy, including the use of: zinc chloride mouthwash 0.2%, SB mouthwash 5% and sterile water mouthwash. The severity of OM in the SB and zinc chloride groups decreased from the end of the first week until the third week but the zinc chloride group performed better, a fact promoting the quality of life, unlike the SB group [ 26 ].…”

“…The aim of the latest and most recent study, which was conducted by Mohammadi et al, was to evaluate the effectiveness of SB and zinc chloride mouthwashes on OM and the quality of life in patients undergoing chemotherapy. The results revealed that zinc chloride and SB mouthwashes were effective in reducing the severity of OM, and subsequently improving the quality of life of patients [ 26 ].…”

“… Choi (2012) [ 24 ] 48 patients under chemotherapy (24 in the experimental arm and 24 in the control arm therapy CHX mouthwash and SB – SB mouthwash Effectiveness of oral care by SB solution and CHX mouthwash on the severity of OM, limitations of daily activities, oral bacterial colonization, and clinical signs associated with infection RCT WHO Oral Toxicity Scale (WHO, 1979) unknown The incidence rate of ulcerative OM in the SB group (25.0%) was significantly lower than that in the CHX group (62.5%). Cabrera-Jaime (2017) [ 25 ] 45 patients under chemotherapy (15 in the experimental arm 1, 15 in the experimental arm 2, 15 in the control arm) therapy SB 5% aqueous solution plus Plantago major extract SB 5% aqueous solution plus CHX 0.12% SB 5% aqueous solution plus SB 5% aqueous solution Mouthwash efficacy; pain intensity, oral intake capacity; and quality of life RCT WHO mucositis scale Clinical nurse plus telephone assessment No significant differences Mubaraki (2020) [ 16 ] 45 patients under radiotherapy (15 in the experimental arm 1, 15 in the experimental arm 2, 15 in the control arm) therapy 0.12% CHX gluconate + SB 3% aqueous solution + nystatin 5000 U/mL and supersaturated calcium phosphate rinse 0.12% CHX gluconate + SB 3% aqueous solution + nystatin 5000 U/mL and an extra-soft toothbrush 0.12% CHX gluconate + SB 3% aqueous solution + nystatin 5000 U/mL Severity of OM RCT Who mucositis scale Oncologic team No differences Mohammadi (2022) [ 26 ] 144 patients under chemotherapy (48 in each group) therapy Zinc chloride mouthwash 0.2% SB mouthwash 5% Sterile water mouthwash Severity of OM, quality of life RCT WHO grading of mucositis Clinical nurse in oncology clinic The severity of OM in the SB and zinc chloride groups decreased from end of the first week until the third week. The zinc chloride group had better performance promoting the quality of life than the SB group.…”

Epipharyngeal Abrasive Therapy Down-regulates the Expression of Cav1.2: A Key Molecule in Influenza Virus Entry

“…Zinc has antibacterial activity against a variety of bacteria, and the Scientific Committee on Consumer Safety considers that it is safe to use water-soluble zinc salts for toothpaste from the age of 6 months (58,59). Zinc chloride used in EAT has been used as a mouthwash for the treatment of oral mucositis in cancer patients undergoing chemotherapy (31,32). Regarding adverse events of EAT, patients may be aware of the temporary pain due to scratching during EAT, but there are no cases of significant side effects in multiple clinical research on EAT (13,26,27).…”

“…ZnCl 2 solution is commonly used as a chemical solution for EAT (13,15,16,(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). In other fields, zinc chloride is also used as a mouthwash for the treatment of oral mucositis (31,32).…”