Comparative Effect of Chamomile Mouthwash and Topical Mouth Rinse in Prevention of Chemotherapy-Induced Oral Mucositis in Iranian Pediatric Patients with Acute Lymphoblastic Leukemia

Background: Oral mucositis afflicts more than 3/4 of patients with cancer under chemotherapy. In acute cases it could lead to brain damage caused by hypoxia and even death due to airway obstruction and reduction of chemotherapy drug dose. We aimed to compare the effects of topical mouth rinse and chamomile mouthwash in prevention of oral mucositis caused by chemotherapy in children with cancer. Methods: The study was a randomized double-blind clinical trial on 62 children aged 6-15 years with acute lymphoblastic leukemia under chemotherapy. The participants were divided randomly into two groups. The first group used topical mouth rinse and the second group started to use chamomile mouthwash a day before chemotherapy through 14 days. Mucous membrane status was assessed before starting the treatment (one day before chemotherapy), 7th and 14th day and it was reviewed based on WHO oral mucositis check list assessment and then registered by the researcher.  Results: The results showed that the frequency of severity of oral mucositis in both groups did not have any significant difference 7 days after chemotherapy (P=0.46). The severity of oral mucositis in those who had used chamomile mouthwash 14 days after chemotherapy was significantly lower than those who used topical mouth rinse (Z=3.23, P=0.001). Conclusion: In short term, using chamomile mouthwash and topical mouth rinse to prevent oral mucositis is effective in children with cancer.  Iranian Registry of Clinical Trials: IRCT2015040821658N1.