SPECIAL ARTICLE Systematic review of basic oral care for the management of oral mucositis in cancer patients and clinical practice guidelines Catherine H. L. Hong 1 & Luiz Alcino Gueiros 2 & Janet S. Fulton 3 & Karis Kin Fong Cheng 4 & Abhishek Kandwal 5 & Dimitra Galiti 6 & Jane M. Fall-Dickson 7 & Jorgen Johansen 8 & Suzanne Ameringer 9 & Tomoko Kataoka 10 & Dianna Weikel 11 & June Eilers 12 & Vinasha Ranna 13 & Anusha Vaddi 14 & Rajesh V. Lalla 15 & Paolo Bossi 16 & Sharon Elad 17 & On behalf of the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO) Received: 20 January 2019 /Accepted: 30 April 2019 /Published online: 8 July 2019 # Springer-Verlag GmbH Germany, part of Springer Nature 2019 Abstract Purpose The aim of this study was to update the clinical practice guidelines for the use of basic oral care (BOC) interventions for the prevention and/or treatment of oral mucositis (OM). Methods A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO). The body of evidence for each intervention in each cancer treatment setting was assigned an evidence level. The findings were added to the database used to develop the 2013 MASCC/ ISOO clinical practice guidelines. Based on the evidence level, one of the following three guideline determinations was possible: Recommendation, Suggestion, No guideline possible. Results A total of 17 new papers across six interventions were examined and merged with a previous database. Based on the literature, the following guidelines were possible. The panel suggests that the implementation of multi-agent combination oral care protocols is beneficial for the prevention of OM during chemotherapy, head and neck (H&N) radiation therapy (RT), and hematopoietic stem cell transplantation (Level of Evidence III). The panel suggests that chlorhexidine not be used to prevent OM in patients undergoing H&N RT (Level of Evidence III). No guideline was possible for professional oral care, patient education, saline, and sodium bicarbonate, and expert opinion complemented these guidelines. * Catherine H. L. Hong denchhl@nus.edu.sg 1 Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, National University of Singapore, 21 Lower Kent Ridge Rd, Singapore 119077, Singapore 2 Oral Medicine Unit, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil 3 Indiana University School of Nursing, Indianapolis, IN, USA 4 Alice Lee Center for Nursing Studies, National University of Singapore, Singapore, Singapore 5 Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India 6 Dental School, University of Athens, Athens, Greece 7 Department of Professional Nursing Practice, Georgetown University School of Nursing & Health Studies, Washington, DC, USA 8 Department of Oncology, Odense University Hospital, Odense, Denmark 9 School of Nursing, Virginia Commonwealth University, Richmond, VA, USA 10 Multi-institutional Clinical Trials Section, Research Management Division, Clinical Research Support Office, National Cancer Center Hospital, Tokyo, Japan 11 Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, USA 12 College of Nursing—Omaha Division, University of Nebraska Medical Center, Omaha, NE, USA 13 Department of Oral and Maxillofacial Surgery, The Mount Sinai Hospital, New York, NY, USA 14 Oral Medicine, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA 15 Section of Oral Medicine, University of Connecticut Health, Farmington, CT, USA 16 Department of Medical and Surgical Specialties, Radiological Sciences and Public Health—Medical Oncology, University of Brescia, ASST-Spedali Civili, Brescia, Italy 17 Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA Supportive Care in Cancer (2019) 27:3949–3967 https://doi.org/10.1007/s00520-019-04848-4