Tips on Coping With Mouth, Gum, and Throat Problems Related to Chemotherapy
Good oral care is important during cancer treatment. Some anticancer drugs can cause sores in the mouth and throat, a condition called stomatitis or mucositis. Anticancer drugs also can make these tissues dry and irritated or cause them to bleed. Patients who have not been eating well since beginning chemotherapy are more likely to get mouth sores.
In addition to being painful, mouth sores can become infected by the many germs that live in the mouth. Every step should be taken to prevent infections, because they can be hard to fight during chemotherapy and can lead to serious problems.
Keeping Your Mouth, Gums, and Throat Healthy
Here are some tips to help keep your mouth, gums, and throat healthy while you have chemotherapy:
- Talk to your doctor about seeing your dentist at least several weeks before you start chemotherapy. You may need to have your teeth cleaned and to take care of any problems such as cavities, gum abscesses, gum disease, or poorly fitting dentures.
- Ask your dentist to show you the best ways to brush and floss your teeth during chemotherapy. Chemotherapy can make you more likely to get cavities, so your dentist may suggest using a fluoride rinse or gel each day to help prevent decay.
- Brush your teeth and gums after every meal. Use a soft toothbrush and a gentle touch. Brushing too hard can damage soft mouth tissues. Ask your doctor, nurse, or dentist to suggest a special toothbrush and/or toothpaste if your gums are very sensitive.
- Rinse with warm salt water after meals and before bedtime.
- Rinse your toothbrush well after each use and store it in a dry place.
- Avoid mouthwashes that contain any amount of alcohol. Ask your doctor or nurse to suggest a mild or medicated mouthwash that you might use. For example, mouthwash with sodium bicarbonate (baking soda) is non-irritating.
Coping With Mouth Sores
If you develop sores in your mouth, tell your doctor or nurse. You may need medicine to treat the sores. If the sores are painful or keep you from eating, you can try these ideas:
- Ask your doctor if there is anything you can apply directly to the sores or to prescribe a medicine you can use to ease the pain.
- Eat foods cold or at room temperature. Hot and warm foods can irritate a tender mouth and throat.
- Eat soft, soothing foods, such as ice cream, milkshakes, baby food, soft fruits (bananas and applesauce), mashed potatoes, cooked cereals, soft-boiled or scrambled eggs, yogurt, cottage cheese, macaroni and cheese, custards, puddings, and gelatin. You also can puree cooked foods in the blender to make them smoother and easier to eat.
- Avoid irritating, acidic foods and juices, such as tomato and citrus (orange, grapefruit, and lemon); spicy or salty foods; and rough or coarse foods such as raw vegetables, granola, popcorn, and toast.
- Consider Calcium phosphate rinse
- Consider chamomile mouthwash
Coping With Mouth Dryness
If your mouth is really dry, try some of these tips:
- Ask your doctor if you should use an artificial saliva product to moisten your mouth.
- Drink plenty of liquids.
- Ask your doctor if you can suck on ice chips, popsicles, or sugarless hard candy. You can also chew sugarless gum. (Sorbitol, a sugar substitute that is in many sugar-free foods, can cause diarrhea in many people. If diarrhea is a problem for you, check the labels of sugar-free foods before you buy them and limit your use of them.)
- Moisten dry foods with butter, margarine, gravy, sauces, or broth.
- Dunk crisp, dry foods in mild liquids.
- Eat soft and pureed foods.
- Use lip balm or petroleum jelly if your lips become dry.
- Carry a water bottle with you to sip from often.
- Consider acupuncture
RESOURCES:
American Cancer Society
http://www.cancer.org
National Cancer Institute
http://www.cancer.gov
CANADIAN RESOURCES:
BC Cancer Agency
http://www.bccancer.bc.ca/default.htm
Canadian Cancer Society
http://www.cancer.ca
References:
Fidler, P, Loprinzi, CL, O'Fallon, JR, et al. Prospective evaluation of a chamomile mouthwash for prevention of 5-FU-induced oral mucositis. Cancer 1996; 77:522.
National Cancer Institute website. Available at: http://www.cancer.gov .
Rydholm, M, Strang, P. Acupuncture for patients in hospital-based home care suffering from xerostomia. J Palliat Care 1999; 15:20.
Last reviewed March 2008 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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