Cancer Treatment Related Mouth Sores
The lining of the mouth, throat, and esophagus are very sensitive to radiation and chemotherapy.
These treatments cause these linings to become red, sore, and swollen. This is called mucositis.
Sometimes white patchy areas develop which can mean a fungal infection has developed. Your
mouth may also become dry as less saliva is being made for a period of time. Your saliva may
become thick and stringy. Taste buds can be affected causing changes in the taste of foods and
liquids. You may notice a change in the texture of foods.
Symptoms of mucositis depend on treatment.
Radiation Chemotherapy Bone Marrow Transplant
Symptoms begin about the
third week of treatment.
Symptoms often appear about
1-2 weeks into therapy.
Symptoms often occur in the
first week after chemo.
Symptoms last for about 4-6
Symptoms improve as you
recover from chemo.
Symptoms last until the white
blood cell count returns.
With proper care, these symptoms will heal. The healing process will vary for each patient.
Please discuss your symptoms with your nurse or doctor.
Tips to help reduce mucositis pain and promote healing
ξ Frequent and thorough mouth care is very important.
ξ Replace your toothbrush every 1-2 weeks.
ξ Do not use mouthwash or rinses that contain alcohol or peroxide. Biotene® products are
good to use.
ξ Ice chips and popsicles can be soothing.
ξ A soft diet may help to lessen discomfort. Avoid hot, spicy, or rough-textured foods
(potato chips, toast, etc.).
ξ Use a water or petroleum based moisturizer to protect your lips.
For patients coming to the clinic for radiation or chemo treatments
1. Brush your teeth at least twice daily with a soft brush or toothette. Use a gentle fluoride
toothpaste such as Biotene or Sensodyne . You may floss gently, if this has been a routine
part of your dental hygiene if your blood counts are not too low. Ask your doctor or nurse if
flossing is okay. Check your tongue and mouth each day for redness or white patchy areas.
If you find redness or white patchy area, report them to your doctor or nurse for treatment.
2. Rinse your mouth after meals and at bedtime. Swish and gargle for 30 seconds then spit out.
Use one of these solutions:
ξ Salt and baking soda: Mix ¼ teaspoon of salt and ¼ teaspoon of baking soda in an
8-ounce glass of warm water.
ξ Salt and water: Mix ¼ teaspoon of salt in an 8 ounce glass of warm water.
ξ Regular tap water.
3. Rinse or clean dentures after meals. You may want to wear your dentures only for meal
4. For thick saliva, gargle often with the salt or baking soda mixture.
5. Numbing gels, sprays, and lozenges may be used. Ask your doctor or nurse if pain
medicines are okay to use.
6. Avoid smoking and drinking alcohol (hard liquor, beer, or wine). Both can dry and irritate
the linings of your mouth.
7. Avoid spicy, hot, rough, or course foods. High calorie and protein, soft, bland, wet foods are
good to eat. Moisten food with sauces and gravy.
8. You may want to avoid citrus juices until your treatment is over and your mouth is healed.
Sometimes diluting citrus juices can make them easier to drink.
9. Cancer treatments can make your teeth more prone to decay. Special fluoride rinses can help
prevent this. Your doctor may also want you to see your dentist before starting treatment.
10. Visit your dentist after you finish your cancer treatment. You should tell your dentist about
your treatments. Contact your cancer doctor or nurse before having oral surgery, or any
other dental work.
For patients who are in the hospital
1. Your nursing staff will encourage you to do your own oral care as described in the previous
section. Your family can be as involved in your care as they wish.
2. Rinse your mouth with normal saline (salt water) at least every two hours.
3. Brush your teeth with a soft-bristle toothbrush after each meal and before bed. If you are not
eating meals, brush your teeth at least twice daily. Toothettes® (small soft sponges on sticks)
may be used in place of a soft-bristle toothbrush if you are unable to tolerate a regular
toothbrush due to pain.
4. A suction device is sometimes helpful if your saliva is thick and you are having trouble
swallowing or clearing secretions.
5. Your doctor may order pain pills, numbing medicines, or pain medicine given through an IV.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 5/2015 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4494.