An Integrative Review of the Role of the Oral and Gut Microbiome in Oral Health Symptomatology During Cancer Therapy

Hayley J. Dunnack

Michelle P. Judge

Xiaomei Cong

Andrew Salner

Valerie B. Duffy

Wanli Xu

microbiome, oral health, radiation therapy, chemotherapy, oral mucositis
ONF 2021, 48(3), 317-331. DOI: 10.1188/21.ONF.317-331

Problem Identification: Both chemotherapy and radiation therapy cause considerable symptom burden on patients’ oral health, influencing nutritional status and quality of life. The role of the oral and gut microbiome in oral health alterations during cancer therapy is an emerging area of science in symptom management.

Literature Search: PubMed®, CINAHL®, and Scopus® were searched for articles published from January 2000 through July 2020.

Data Evaluation: Articles published in English that were focused on chemotherapy and/or radiation therapy were included in the review.

Synthesis: Of the 22 identified studies, 12 described oral health symptoms during chemotherapy and radiation therapy for head and neck cancer. Ten studies assessed symptoms during treatment for a variety of solid tumors and blood cancers, with four of these describing microbial interventions for the management of oral mucositis. Interventions varied, but the results supported the benefits of probiotics and synbiotics in reducing mucositis severity. Overall, less diverse oral and gut microbiome environments were associated with increased severity of oral health symptomatology.

Implications for Practice: Additional research is needed to determine how the oral and gut microbiome and microbial interventions may be used to improve oral health management during cancer treatment.

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