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Cancer

Mucositis or Sore Mouth

During cancer treatment, the lips, mouth and throat sometimes become tender, red and irritated, and sores may develop. Most cancer patients will not develop oral mucositis. Those undergoing treatment for head and neck cancers, or those receiving bone marrow transplants, are more likely to develop this condition.

Oral mucositis can make it difficult to eat, drink or talk, and can put you at an increased risk for infection. Oral mucositis from chemotherapy typically occurs intensely over a short time. When the condition results from radiation therapy, it typically occurs less intensely for a longer time.

It is important to be treated by a knowledgeable dental professional before beginning your cancer treatment. Your health care provider can consult with your dentist regarding your care.

If You Have Mucositis You May See:
  • Red, inflamed areas in your mouth (they may have white spots in the center)
  • Shiny, swollen tissues in your mouth including the tongue
  • A yellowish or white film on areas in the mouth
  • Blood in the mouth or saliva
  • Areas of open sores or ulcers in your mouth

When Mucositis Develops You May Feel:
  • Pain and discomfort in the mouth
  • A raw feeling in the throat
  • Sticky secretions or saliva
  • Swollen tissues in your mouth

What the Patient and Caregiver Can Do:
Doing oral care on a frequent basis daily plays an important role in oral health during cancer therapy. You may not be able to prevent all problems, but it will decrease the severity of the problems. Clean your teeth after eating and at bedtime using a soft bristled toothbrush.  Always use non-irritating toothpaste. Avoid using toothpastes with strong whiteners, which may cause irritation.  Rinsing your toothbrush in warm water will help to soften the bristles. If you still experience pain with brushing, you may need to use soft foam swabs.
 
Oral Care Solutions to try:
 – Normal saline solution (salt water): You can obtain bottled normal saline, or you can prepare this at home by adding one teaspoon of table salt to one quart or four cups of plain water. Shake or stir the solution. Keep it with you for regular use. If you make more solution than you will use in one day, keep the remainder in the refrigerator. Note: if your tap water contains germs you should obtain another source of water to use. If you are not sure about the safety of your water supply, check it out with your local health department.
 – Baking soda solution: You can prepare this at home by adding 1 teaspoon of baking soda to 8 ounces of water.
 – Salt and soda solution: You can prepare this at home by adding 1/2 teaspoon of table salt and 2 teaspoons of baking soda to one quart or four cups of plain water. Shake or stir the solution. Keep it with you for regular use. If you make more solution than you will use in one day, keep the remainder in the refrigerator. Avoid using mouth rinse products that have glycerin or alcohol as they can cause drying in your mouth. The alcohol can be irritating to your mucous membranes.
 – Drink plenty of fluids to avoid dehydration. Keeping fluids close by you will help you to accomplish this. Avoid acidic drinks such as orange or grapefruit juice if sores are present in your mouth. Avoid drinking anything that is extremely hot or cold, as extremes in temperature can also be painful to the sensitive tissues in your mouth. Apply lip moisturizer or non-drying lip balm to keep your lips moist and avoid cracking. Do not bite or chew on your lips.

A word about dentures: If you have dentures or other dental appliances, be alert to special concerns. The fit of these devices may change during your cancer therapy and they need to be adjusted. If you have sores in your mouth you should limit the amount of time you have the devices in your mouth. Keep these devices as clean as possible so that they do not cause infections in your mouth. Brush them several times a day with a cleansing solution. Soaking your dental appliance in an antimicrobial solution will also help to
prevent infections. Always remove these devices during oral care so that you clean all areas of your mouth.