A dry mouth can be a distressing side effect of cancer treatments and if prolonged
can lead to pain and soreness. A dry mouth can lead to secondary infection and
bleeding. Lack of saliva then causes difficulty swallowing as it is hard to chew
food and form a bolus. A dry mouth also causes problems with speech as the
tongue tends to stick to the side or roof of the mouth. This page describes the
common causes of a dry mouth during or after cancer treatments and suggests some
practical tips which may help.
Common causes of
a dry mouth:
Mouth breathing e.g. a blocked nose
Painkillers - opiates, codeine
Antisickness - hyoscine
Antidepressants or amtitrypiline
Damage to the salivary glands - particularly after
radiotherapy to the head and neck area
After prolonged chemotherapy regimens, saliva production can temporarily reduce
Dehydration from any cause
High calcium in blood stream (hypercalcaemia)
Previous medical conditions e.g. autoimmune diseases affecting the gland
Tips for a dry mouth
care when you have a dry mouth can help to keep the mouth clean, moist and
comfortable. It is especially important to take good care of your mouth while
you are receiving treatment: Careful attention to mouth care will help reduce
the risks of infection and the following instructions are designed to help you
keep your mouth clean and comfortable. If a dry mouth becomes inflamed this is
called oral mucositis often can be painful, and this in turn can make it
difficult to eat and drink.
Clean teeth thoroughly but gently
after each meal and before going to bed. If the gums are delicate it is better
to use a soft toothbrush (baby/infant).
Brand name antibacterial mouthwashes
such as Corsodyl may be used but are quite strong and may damage the fragile
lining of your mouth whilst on treatment. Check with nursing staff for further
Saline mouthwashes are recommended
if tolerable; 5 mls salt: 500 mls tepid water; (1 tsp. salt: one pint tepid water).
If you are suffering from a mark dry mouth, this supervising doctor needs to be
told, otherwise, the following suggestions may help:
frequent drinks, even just a few sips at a time to keep your mouth moist.
Fizzy drinks may be most refreshing
- Avoid alcohol or smoking
sucking ice cubes/ice lollies (these can be flavoured with cordials, fruit
juice or juice based supplements
making home-made lollies or in the freezer using fruit juice and/or
food with lots of gravy or
sauces, butter, custard, cream
people report that chocolate and pastry stick to the roof of the mouth-avoid
them if they do
sucking sugar free boiled sweets, fruit drops/pastilles, chewing gum or try eating
pineapple chunks or grapefruit segments to increase saliva flow
saliva preparations are available and can be prescribed by your doctor if
a mouthwash and brush your teeth regularly
lips moist with lip balm
Avoid wearing denture
It may be necessary to change the diet to foods
which are soft and moist. Also if there are signs of secondary infection
further treatment may be needed.
Signs of infection in the mouth:
pain and swelling
Treating a painful mouth
- Fundal (candida) with
antifungals such as fluconazole
Saline mouthwashes (see above) - Use
two tablets in tepid water, swill around the mouth for two to three minutes but
do not swallow. Useful before meals but it is best not to eat or drink anything
for 10 minutes after using the mouthwash, to gain maximum effect from it. May be
used frequently during the day, provided they are not swallowed.
Soluble Paracetamol mouthwash/gargle.
Sore lips may be helped with Paracetamol mouthwash.
Vaseline is also useful to prevent dryness and cracking.
- Oral barrier gels (e.g.gelclair)
- Painkilling brand name mouthwashes, e.g. Difflam may be useful but please check
with nursing staff before using as some consultants prefer not to prescribe
In some cases you will be
advised to suck ice/ice-lollies immediately prior to and during
chemotherapy. This is to reduce damage from certain drugs.
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