What is Chemo Mouth

If you have cancer and are getting chemotherapy, you probably expect to have some side effects. Fatigue, hair loss, and nausea may come to mind. But you may be surprised to learn that chemo can affect your mouth, too.

What Is Chemo Mouth?

With oral mucositis, the inside of your mouth becomes swollen and irritated, and sores may form. When oral mucositis occurs during chemotherapy, it’s commonly known as “chemo mouth.”

Chemotherapy attacks fast-growing cells throughout the body. Cancer cells are fast-growing, but so are the cells inside the mouth and digestive tract. Chemotherapy drugs can’t distinguish cancer cells from these “good” cells.

All too often, chemo mouth is the result. Symptoms include:

  • Mouth pain, including of the tongue and gums.
  • Mouth sores.
  • Infection.
  • Bleeding.

Chemo mouth often starts around one to two weeks after you begin cancer treatment.

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Can I Prevent Chemo Mouth?

You may not be able to prevent chemo mouth entirely, but some pretreatment planning may help. If possible, complete any needed dental work several weeks before starting cancer treatment. That way, your mouth will have time to heal before chemo begins.

If you wear dentures, make sure they fit properly before starting chemo. Your dentist will want to smooth out any sharp edges before your mouth becomes extra sensitive from chemo.

Keep your dentures out as often as possible during treatment. Brush, rinse, and scrub them as your dentist directs. Keep them moist when not using them.

Stay hydrated throughout chemo treatment to prevent dry mouth. Drink lots of water so your mouth stays moist, which discourages sores and tooth decay. Your care team may also give you ice chips to suck on during your chemo appointments.

Use lip care products frequently to keep your lips from cracking or drying out. Some doctors suggest avoiding petroleum-based lip products as they may be too drying.

Maintain good oral hygiene.

How to Get Rid of Chemo Mouth

Your care team will have helpful suggestions for how to manage chemo mouth. Common suggestions include:

  • Choose soft foods that have plenty of protein and vitamins.
  • Stay away from hard foods like chips or crusty bread.
  • Limit spicy food.
  • Avoid acidic foods like citrus and tomatoes.
  • Take care not to burn your mouth with hot food or drinks.
  • Eat frozen or cold foods if they appeal to you. Popsicles, ice cream, and milkshakes are all good choices. Chilled fruit like watermelon, berries, or peaches can soothe sore mouths.
  • Chew gum or suck on sugar-free hard candy to help keep your mouth from drying out.
  • Over-the-counter saliva stimulating products (i.e. xylitol melts/tabs).
  • Oral rinses with salt water and baking soda.

Maintain good oral hygiene

It’s especially important to maintain good oral hygiene while receiving cancer treatment. If you don’t take good care of your teeth, too many bacteria can grow in your mouth.

During treatment, poor oral hygiene is more likely to lead to an infection in your mouth. Any infection during chemo is concerning. Your weakened immune system is more likely to let the infection spread and may cause serious illness.

Follow these tips for good oral care:

  • Rinse your mouth before and after eating. Finish your day with one last rinse before bedtime. Make sure your rinse is alcohol-free so as not to dry out your mouth.
  • Floss gently every day if you can tolerate it.
  • Brush frequently using a soft toothbrush. Rinse the brush carefully after each use and let it air dry.
  • Choose a toothpaste with fluoride. Toothpastes with tooth whiteners can irritate your mouth, so save them until you’re done with treatment.

If toothpaste makes your mouth sore, the National Library of Medicine suggests brushing with a solution of one teaspoon of salt mixed with four cups of water. Pour a small amount into a clean cup. Dip your toothbrush into the cup each time you brush.

Your doctor may give you specific rinsing instructions. Your doctor may also recommend or prescribe special mouthwashes to lubricate your mouth or relieve pain.

When to Call Your Care Team About Chemo Mouth

It is always appropriate to contact your doctor whenever you have questions about your care.

Your cancer care team will ask about or examine your mouth at office visits. But contact them in between visits if you have:

  • Worsening pain or new sores in your mouth.
  • Signs of infection like fever, chills, or unusual redness or swelling in your mouth.
  • Persistent feeling of dry mouth even after practicing good home care.
  • Problems eating, drinking, or swallowing.

Follow your care team’s instructions regarding pain relief for chemo mouth.

How Long Does Chemo Mouth Last?

Chemo mouth can be very uncomfortable, but it won’t last forever. Symptoms usually get better and disappear within a few weeks after you finish treatment. Symptoms may also improve with slight changes to your chemotherapy dose as determined by your doctor.

Chemo Mouth: It's Real, Common and Manageable. Moffitt Cancer Center. Link

Oral Mucositis - Self-Care. Medline Plus. The National Library of Medicine. Link

Mucositis. National Health Service (UK). Link

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