Effectiveness of triclosan in the management of radiation-induced oral mucositis: A randomized clinical trial

Introduction: Oral care in cancer patients is an important aspect in the quality of life of patients undergoing cancer therpay. Mucositis, trismus, salivary gland dysfunction are the main complications of the cancer therapy, which lead to long-term comlications such as radiation caries, poor oral hygiene and osteoradionecrosis. A timely oral evaluation and intervention in these patients can reduce the severity of the potential complications. Triclosan is an antibacterial agent widely used in periodontal therapy, the effectiveness of triclosan in the management of radiation induced oral mucositis is evaluated here.
Aims: 1) To determine the effectiveness of triclosan in the management of radiation-induced oral mucositis. 2) To compare the effectiveness of triclosan mouth rinse with conventional sodium bicarbonate mouth rinse.
Materials and Methods: Twenty-four patients who underwent radiation therapy for oral cancer and subsequently developed oral mucositis were included in the study. They were randomly allocated into two groups on noticing grade I mucositis (erythema). The study group was advised to use triclosan mouthwash containing triclosan 0.03% W/V and sodium bicarbonate 2 mg mouth wash for the control group. A weekly follow-up evaluation of body weight, food intake, pain and grading of mucositis were made during the radiation treatment period and post radiation treatment period.
Results: Both the groups were statistically identical. All the 24 patients in both the groups passed through grade 3 mucositis on the last day of radiotherapy. However, 10 patients in the control group and only one patient in the study group entered to grade 4 mucositis. A definite change was noticed in the severity of the mucositis, food intake and weight loss. The control group took more than 45 days to resolve while the study group took only less than 28 days.
Discussion: The results of the study were evaluated and tried to formulate a hypothesis so as to explain the less severity and early resolution of mucositis in the study group.
Conclusion: Triclosan mouthwash was found to be effective in reducing the severity of radiation- induced oral mucositis and helped in early reversal of symptoms during post treatment period. However, further studies are necessary to confirm this observation.