Supportive Care in Cancer

, Volume 21, Issue 4, pp 1113–1120

Implementation of a hospital oral care protocol and recording of oral mucositis in children receiving cancer treatment

A retrospective and a prospective study
  • Akram F. Qutob
  • Gabrielle Allen
  • Sumant Gue
  • Tamas Revesz
  • Richard M. Logan
  • Dorothy Keefe
Original Article



This retrospective/prospective study was carried out to implement a standardized hospital oral care protocol and record the incidence of oral mucositis for inpatients with childhood cancer.


The implementation process included stages of collaboration, consultation, education, and evaluation. The retrospective part of the study documented the existing hospital oral care protocol and audited medical records of all pediatric patients diagnosed with cancer over a 12-month period. The frequency of recorded oral mucositis and the rate of referral to the pediatric dentistry department were assessed. Following evaluation of the retrospective study, the literature was searched to create a new hospital oral care protocol. Referral to the dental department was standardized and frequent in-service presentations were given to staff. The oral mucositis scale was recorded daily for all inpatients, and compliance rates were assessed.


Fifty-nine patients’ medical records were audited during the retrospective study. Oral mucositis prevalence was clearly documented at 34%, while an additional 20% lacked a definitive diagnosis. During the prospective study, 38 patients were followed and had a verified incidence of oral mucositis of 33%. The rate of compliance of implementing the oral mucositis scale improved from 41% during the first 4 months to 87% during last 3 months. Referral rates to the dental department increased from 53% during the retrospective study to 100% during the prospective study.


Mutual understanding and collaboration between the oncology and dental departments in hospitals is crucial for standardizing patient care and for improving oral care standards.


Oral care protocol Oral mucositis Childhood cancer Implementation Children Hospital 


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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Akram F. Qutob
    • 1
    • 2
    • 3
  • Gabrielle Allen
    • 3
  • Sumant Gue
    • 2
    • 3
  • Tamas Revesz
    • 4
  • Richard M. Logan
    • 2
  • Dorothy Keefe
    • 5
  1. 1.Faculty of DentistryKing Abdulaziz UniversityJeddahSaudi Arabia
  2. 2.School of Dentistry, Faculty of Health SciencesThe University of AdelaideAdelaideAustralia
  3. 3.Department of Paediatric DentistryThe Women’s and Children’s HospitalNorth AdelaideAustralia
  4. 4.Department of Clinical Haematology/OncologySA Pathology at Women’s and Children’s HospitalNorth AdelaideAustralia
  5. 5.School of Medicine, Faculty of Health SciencesThe University of AdelaideAdelaideAustralia

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