“Magic Mouthwash” Effectively Reduces Oral Mucositis Pain

Dentistry Today


An oral rinse called “magic mouthwash” by its developers including diphenhydramine, lidocaine, and antacids significantly reduced pain from oral mucositis in patients receiving radiation therapy for head and neck cancers compared to a placebo, according to a multi-institution, randomized, double-blind, placebo-controlled, phase III clinical trial.

“Our group published a study in 2012 showing that an oral rinse of doxepin reduced oral mucositis-related pain, compared to placebo,” said Robert Miller, MD, an emeritus Mayo Clinic radiation oncologist. “However, there were no large randomized controlled trials studying the potential benefits of magic mouthwash.”

Studying 275 patients between November 2014 and May 2016, the researchers found that pain related to oral mucositis was significantly reduced following both doxepin and magic mouthwash rinses versus a placebo. They also found that both doxepin and magic mouthwash rinses were well tolerated by patients.

“Radiation therapy may cause mouth sores because it is designed to kill rapidly growing cells such as cancer cells,” said coauthor Terence Sio, MD, a Mayo Clinic radiation oncologist in Arizona.

“Unfortunately, healthy cells in your mouth also divide and grow rapidly and may be damaged during radiation therapy, which can cause discomfort. We’re glad to have identified a proven method to help treat the discomfort of this side effect,” said Sio.

The research was conducted through the Alliance for Clinical Trials in Oncology and included investigators from: 

  • Mayo Clinic campuses in Arizona, Florida, and Minnesota
  • Wichita Community Oncology Research Program in Wichita, Kansas
  • Southeast Clinical Oncology Research Consortium Community Oncology Research Program, Spartanburg, South Carolina
  • Roswell Park Comprehensive Cancer Center, Buffalo, New York
  • The Ohio State University Wexner Medical Center, Columbus, Ohio

The study, “The Search for an Effective Therapy and Pain Relief for Oral Mucositis,” was published by JAMA.

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