Mouthcare Guidelines

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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.  One option for relieving the pain is Gelclair, an oral gel which forms a protective barrier over the inside of the mouth, a little like a dressing.  This can make the mouth less painful and can make it easier to eat and drink. (click here for more information)


PREVENTATIVE ADVICE
 
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 are recommended if tolerable; 5 mls salt: 500 mls tepid water; 1 tsp. salt: one pint tepid water.


TREATING A PAINFUL MOUTH 

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. 
As mentioned above an oral gel gelclair 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.
 


GENERAL TIPS FOR A SOUTH / DRY MOUTH

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. If the above measures are not helping the pain, do not hesitate to call us. You may have an infection (see next section) or you may need stronger pain- killers which the doctor can prescribe. A sore mouth may affect your appetite. 

If you are worried about weight loss, please discuss with nursing staff and check for:

 

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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