Good mouth care helps to keep the mouth clean, moist and comfortable. It is
especially important to take good care of your mouth while you are receiving
treatment:
Chemotherapy affects rapidly dividing normal
cells such as those that make up the lining of the mouth and gut. This may
result in inflammation and ulceration of the mouth lining causing pain and
discomfort; Radiotherapy in or around the area of your mouth can make
it dry and sore. Inflammation of the mouth is called mucositis. In these cases
or if your white cell count is low after treatment, you will be susceptible to
oral infections such as thrush (candida) or cold sores (herpes simplex). 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. Oral mucositis often can be
painful, and this in turn can make it difficult to eat and drink.
Treating and preventing a painful mouth
Tell your medical team if you develop a sore mouth, particularly if you have any
of the following symptoms as these are more often associated with infection:
- red areas
- blisters
- white spots
- coated tongue
- bleeding
Your medical team will often prescribe an anti-fungal lozenge or tablet. If
severe they may also reduce your chemotherapy dose at the next cycle. Otherwise
the following tips may help:-
-
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 advice.
- Saline mouthwashes (5 mls salt: 500 mls tepid
water; 1 tsp. salt: one pint 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.
- Lip salve is also useful to prevent dryness and cracking. - especially
natural varieties
- An oral barrier gel maybe is available which forms a protective barrier over the inside of the mouth.
- 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 them.
- 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.
-
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 advice.
- Suck sugar free sweets (be careful too many cause diarrhoea). Be careful with
boiled sweets in case they cut your mouth.
- Spicy, acidic or salty foods can be uncomfortable.
- A yougurt with a meal is useful lubrication.
- Use plenty of fluids, e.g. gravy, sauces, melted butter or margarine to keep
foods moist.
Aim for small and frequent meals, i.e. take something nourishing every two
hours if you cannot manage large meals.
- Have soft foods or cold foods.
- Supplement your diet with Complan or Build Up.
- Use a straw for drinking.
- Avoid tobacco and alcohol.
- Avoid wearing dentures.
Common causes of a dry mouth
- Mouth breathing e.g. a blocked nose
- Painkillers - opiates, codeine
- Antisickness - hyoscine
- Antidepressants or amtitrypiline
- Problems with the salivary glands - Particularly after radiotherapy to the
head and neck area
- After prolonged chemotherapy regimens the production of saliva can
temporarily reduce.
- Dehydration from any cause
- High calcium in blood stream (hypercalcaemia)
Tips
for a dry mouth
Good 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.
-
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:
-
Have 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
- Try
sucking ice cubes/ice lollies (these can be flavoured with cordials, fruit
juice or juice based supplements
- Try
making home-made lollies or in the freezer using fruit juice and/or
supplements
- Moisten
food with lots of gravy or
sauces, butter, custard, cream
- Some
people report that chocolate and pastry stick to the roof of the mouth-avoid
them if they do
- Try
sucking sugar free boiled sweets, fruit drops/pastilles, chewing gum or try
eating pineapple chunks or grapefruit segments to increase saliva flow
- Artificial
saliva preparations are available and can be prescribed by your doctor if
felt appropriate
- Use
a mouthwash and brush your teeth regularly
- Keep
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.
Further general information Your doctors and specialist nurses are in
an ideal position to give you relevant information on your disease and treatment
as they know your individual circumstances. Cancerbackup
has a help line (0808 800 1234) and a prize winning video
available in English, Italian, Urdu, Bengali,
Gujarati & Hindi explaining Radiotherapy & Chemotherapy. Cancernet.co.uk
has over 500 pages describing cancer, its management, practical tips and tool
which patients, their carers and their doctors have found helpful during the
cancer journey.
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