Effects of Hydrogen Water Gargling on Oral Mucositis and Pain in Head and Neck Cancer Patients: A Randomized Controlled Pilot Study
Tsai HT et al. · Integr Cancer Ther. 2026;25:15347354261463550.
What kind of evidence is this?
Human
Single-center, single-blind, parallel randomized controlled pilot trial
Oral and dental health
Other forms
Not reported in this record.
Not reported in this record.
Methods at a glance
Adults with head and neck cancer receiving radiotherapy or concurrent chemoradiotherapy and experiencing oral mucositis
31 analyzed: H₂-water n=16; distilled-water n=15
2 weeks; assessments at baseline and days 1, 3, 7 and 14
Gargling with 20 mL nano-hydrogen water for 30–60 seconds every 4 hours, at least 3 times/day
H₂ dispersed in water as nanobubbles for oral gargling — H₂ only, not Brown’s gas.
Mean nanobubble diameter about 145 nm and concentration 2.79–4.89 × 10⁸ bubbles/mL within 1 hour of preparation; the article does not report dissolved H₂ in mg/L or ppm.
Not applicable — gargled water, not gas inhalation.
No O₂ was co-delivered as part of the intervention.
20 mL distilled water gargled on the same schedule plus usual care
Outcomes and reported result
WHO oral-mucositis grade, pain, oral frailty and head-and-neck-cancer quality of life
The paper reports improvements in oral-mucositis grade, pain and quality of life in the H₂-water arm; oral frailty did not differ. The displayed analyses emphasize within-group changes, and baseline mucositis severity was imbalanced.
Intervention, main results, limitations and access status checked in the open-access full text; independent appraisal remains incomplete.
A reported association, difference or mechanism is not automatically a clinical benefit. Null findings, outcome type, study design and precision all matter.
Cautions and applicability
Only 31 analyzed participants, single blinding, two-week follow-up, multiple outcomes and an important baseline imbalance: grade-4 mucositis occurred only in the H₂-water group. The article’s tables emphasize within-group tests, which do not by themselves establish a between-group effect.
Head and neck cancer patients with treatment-related oral mucositis under the study’s gargling protocol; not prevention or treatment of other oral conditions.
Not reported in this record.
Not reported in this record.
Not reported in this record.
No single-study GRADE certainty rating is assigned. Certainty is assessed by important outcome across a complete eligible evidence set, not by attaching a final grade to one source.
Sources and record status
PMID: 42338291 · DOI: 10.1177/15347354261463550
Open-access full text is available through PMC and the publisher.
Open-access PMC and publisher full texts plus PubMed record.
2026-08-10