Photobiomodulation (PBM) to help oral mucositis

Information about photobiomodulation (PBM) – a form of infrared light therapy. We explain how PBM can be used to help reduce the severity of oral mucositis, in patients undergoing chemotherapy or radiotherapy. 

PBM is a non-invasive, painless therapy which uses infrared light to help repair tissue and reduce inflammation. 

It is used for pain relief, wound healing and to help prevent and treat severe oral mucositis in children undergoing chemotherapy or radiotherapy. 

PBM is recommended by NICE (National Institute of Clinical Excellence) as a way to reduce the severity of oral mucositis.

Orial mucositis is the inflammation of the mucous membranes that line the mouth. It can cause: 

• sore and swollen gums, lips and tongue
• mouth ulcers
• sore throat
• difficulties with swallowing, talking and eating. 

Oral mucositis is a side effect of chemotherapy and radiotherapy. It is particularly common in children receiving high dose chemotherapy and/or Total Body Irradiation (TBI) before a haemopoietic stem cell transplant (HSCT). 

The infrared light stimulates the cells to reduce inflammation, speed up healing and helps to lower the risk of infection. 

PBM helps to reduce the need of nutritional support and the need for opioid pain relief such as morphine. 

The treatment will be used daily until count recovery of neutrophils of 0.2 (approximately two to three weeks post-transplant). 

A handheld device – which we call a ‘lollipop’ – is covered in a disposable sleeve. 

You child can hold the lollipop themselves – it is not hot or painful to use. 

They will put the lollipop into their mouth, and hold it directly on to seven treatment areas:

• left cheek
• lips and closed mouth
• right cheek
• under chin
• throat 
• open mouth with tongue flat
• open mouth with tongue raised

Even if your child cannot put the lollipop very deep into their mouth it will still be beneficial.

The lollipop emits a strong red light – your child might like to wear sunglasses to help reduce the glare. We can provide these.

The treatment takes seven to nine minutes, with the lollipop held over each treatment area for one minute. 

PBM is very safe – to date, no adverse side effects have been reported.

The infrared light is not harmful to the eyes.

If you have any questions or concerns, please contact Johanna Lee (Practice Educator) or Sian Essex (BMT Clinical Nurse Specialist)

Phone: 020 7405 9200 ext. 5083, Monday to Friday, 8am to 6pm.

Or email: Johanna.Lee@gosh.nhs.uk or Sian.Essex@gosh.nhs.uk