ORAL MUCOSITE AND EMPLOYMENT OF LOW INTENSITY LASER

Abstract

Background: Oral mucositis is an inflammatory toxic reaction of the oral mucosa due to exposure to chemotherapeutic agents or ionizing radiation, being one of the most frequent side effects of antineoplastic treatment. It is found in almost 100% of patients submitted to radiotherapy in the head and neck region and can cause dysphagia and infection by opportunistic microorganisms. It is considered the most common cause of oral pain in these patients. This pain can reach significant levels, compromise nutrition, and even lead to treatment modification or discontinuation. Objective: to describe the efficiency of low level laser therapy in the control of pain and oral mucositis. Methods: case report and literature review contextualized to the proposed theme. Results: J.A.P, male, 56 years old, fisherman. Diagnosed with squamous cell carcinoma (AP no 173864) in posterior wall of oropharynx. The recommended antineoplastic treatment involved surgery with chemotherapy (CDDP weekly) and adjuvant radiotherapy. The patient was being submitted to radiotherapy with 180 cGy / day. At the 11th week of therapy, he developed severe pain and difficulty feeding and was referred to the Dentistry Oncoly Center service of the Oswaldo Cruz University Hospital. On intraoral examination was verified the presence of ulcerations on the back of the tongue, buccal floor and right and left jugal mucosa, characterizing oral mucositis grade III, according to the classification of the World Health Organization. And in the Numerical Pain Scale the patient listed the number 8. The antineoplastic radiation therapy was temporarily suspended. The Standard Operational Protocol for Oral Care (POP-Oral) of the service was instituted and the use of low-level laser (Laser Duo MMO) with the wavelength of 660nm, power of 35mW. In the second session of photodynamic therapy, the patient already reported improvement in food acceptance, and listed number 5 in the Numerical Pain Scale. Photodynamic therapy was maintained until complete remission of pain and normalization of oral functions, corroborating with the therapeutic effects reported in the scientific literature, such as analgesia, antiinflammatory properties, tissue biostimulation and antimicrobial potential. JAP resumed and completed the antineoplastic treatment. Conclusion: The low-level laser photobiomodulation therapy has proven efficacy in the literature and was very useful in the treatment of mucositis with resolution of the immediate pain and tissue repair in 15 days.