Effect of chewing gum on the management of chemotherapy-induced oral mucositis in children: Systematic review of experimental studies

Eur J Cancer Care (Engl). 2022 Nov;31(6):e13727. doi: 10.1111/ecc.13727. Epub 2022 Oct 14.


Objective: It was aimed to systematically synthesise the available literature on examining the effect of chewing gum in the management/reduction of chemotherapy-induced oral mucositis in children.

Methods: The PRISMA was followed for the systematic review. All published studies obtained from the relevant databases were examined while the research question and inclusion and exclusion criteria were considered. The Joanna Briggs Institute (JBI) critical appraisal tools were used to evaluate the quality of the studies.

Results: A total of five studies met the inclusion criteria: three randomised controlled trials (RCT) and two quasi-experimental studies with a total of 461 paediatric oncology patients were included. Heterogeneity was found across all studies regarding the application of gum chewing and regarding the effectiveness of gum chewing. Two RTCs and one quasi-experimental study reported that gum chewing is not effective to reduce severe oral mucositis, but effective to reduce moderate and mild oral mucositis, and one RTC reported that gum chewing is not effective to reduce oral mucositis.

Conclusion: Experimental studies particularly randomised controlled trials using rigorous designs, consistent outcome measures, and larger sample sizes are required to determine the efficacy of chewing gum in reducing chemotherapy-induced oral mucositis in paediatric oncology patients. Study was registered in PROSPERO and number was CRD42022328916.

Keywords: chemotherapy; chewing gum; children with cancer; oral mucositis; paediatric oncology; systematic review.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Antineoplastic Agents* / adverse effects
  • Chewing Gum*
  • Child
  • Humans
  • Neoplasms / drug therapy
  • Randomized Controlled Trials as Topic
  • Stomatitis* / chemically induced
  • Stomatitis* / prevention & control


  • Antineoplastic Agents
  • Chewing Gum