Early mucositis is a frequent, dose-limiting side effect of radiotherapy of head and neck tumours. A variety of experimental and clinical studies on its prophylaxis and management have been carried out. However, for most approaches, no efficacy has been clinically demonstrated. This review discusses the clinical strategies and preclinical approaches for the amelioration of oral mucositis. In addition to thorough dental restoration, an optimization and intensification of oral hygiene with frequent mouthwashes is effective for the prevention of oral mucositis. Intense supervision of the patient is recommended. The necessity for a percutaneous endoscopic gastrostomy is dependent on the status of the patient and the expected impairment of food uptake. Therapeutic intervention is restricted to local or systemic analgesia and the local application of antimycotics and antibiotics.