Oral mucositis (OM) is a distressing toxic effect of chemotherapy and radiotherapy. It can increase the need for total parenteral nutrition and opioid analgesics, prolong hospital stays, increase the risk of infection, and greatly diminish a patient's quality of life. Nurses play a critical role in the assessment and management of OM. However, nurses face several significant challenges in effectively managing OM. First, the assessment and management of OM is inconsistent across Europe. Second, available treatment options for OM are largely ineffective, aimed at palliation of symptoms, and do not target the underlying pathophysiology. Nursing care has focused primarily on symptom management and pain control. With recent advances in the understanding of the pathobiology of OM and the development of interventions, it is hoped that the quality of care provided to patients will improve dramatically as new agents should allow the goal of OM management to shift from symptom relief to protection and prevention. Nurses should be educated about these novel options for the management of OM.