The Importance of Oral Mucositis Scoring Tools among Children with Cancer: Review of Literature

Arwa Assaf


Background: In studies that investigate oral mucositis (OM) among children, several scoring tools have been used for different purposes, and adult tools have been tested and validated in pediatric settings. Nurses are challenged to choose the most appropriate assessment tool that accurately reflects OM in children and is easy to use in the clinical setting.

Objective: To review the literature related to OM among children, specifically, to identify an assessment tool that may be appropriate to use in children and to highlight the scoring tools that pediatric oncology nurses can use in daily practice.

Data Sources: The PubMed and EBSCO databases, with a publication range from the years 2000 to 2010, were searched for studies published regarding OM in children with cancer.

Data Synthesis: Several oral mucositis scoring tools have been created for adults; however, a lack of pediatric OM scoring tools was noticed.

Conclusion: To date standard practices for OM assessment that particularly focus on the special aspects in children do not exist. However, there is a new pediatric OM scoring tool, the Children Oral Mucositis Assessment Scale (ChIMES) and other valid tools which can be used in the pediatric setting, such as the Oral Mucositis Daily Questionnaire, the Oral Mucositis Assessment Scale (OMAS), and the Oral Assessment Guide (OAG).

The implication for nursing is that nurses have to evaluate the oral cavity as a routine nursing practice by a valid and appropriate scoring tool. The performance of an effective assessment requires skillful and trained nurses who are knowledgeable about the anatomical changes of the oral cavity, patient’s risk factors and the circumstances that predispose OM. Moreover, the standard criteria for an oral assessment are needed.


Oral mucositis, children, cancer, assessment tool, scoring, scale, measurement

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