Mouth Care Information for Patients


(Remember, to return to the Cancer Information Services Website just close this window)

Following many types of chemotherapy, you may suffer from a sore mouth and mouth ulcers. This is because the 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's lining, causing pain and discomfort. Some types of chemotherapy also lower your white cell count, making you particularly susceptible to infection. There is a risk that a mouth infection could spread to your blood stream, or elsewhere in your body. Due to these factors, it is very important that you take good care of your mouth.

If your mouth feels sore, check for:

Red areas
Blisters
White Spots
Coated Tongue
Bleeding

NB: Radiotherapy aimed in or around the area of your mouth can make it dry and sore.

Please inform the doctor/nurse if your mouth is painful when you attend your clinic. The doctor may need to prescribe pain killers, mouthwashes and treat any infection. If your clinic appointment is not due for a while, contact your GP or Hospital for advice.


BRUSHING YOUR TEETH
It is important to use a soft, small toothbrush, as it reduces the chances of bleeding gums if your platelet count is low. The brush should be left to dry after use, as bacteria multipy on a constantly wet brush.

MOUTHWASHES
It may be painful to clean your teeth and a mouthwash be used instead of, or as well as toothpaste, to keep mouth clean. Mouthwashes may be diluted water if your mouth is very sore, or you find them too strong.

Corsodyl - an antiseptic mouthwash which should be used at least four times a day, and more regularly if your mouth is very sore. Use it post meals.

Difflam -if used before performing mouth care, make it less painful.

Lignocaine and Hydrocortisone -can be used before meals to reduce pain when eating.

Normal Saline -5 mls salt: 500 mls tepid water; 1 tsp salt: one pint tepid water can be used instead of Corsodyl/Difflam.

Soluble paracetamol mouthwash / gargle -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 / 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.

Sore lips may also be helped with paracetamol mouthwash.
Vaseline is also useful to prevent dryness and cracking.

ANTI-FUNGALS
In addition to mouthwashes you may be asked to take anti- fungal medication. These prevent fungal infections such as oral thrush. Tablets will be prescribed to try and prevent you getting thrush. If however you do develop a white coated mouth, inform the doctor/nurse, and they will prescribe a liquid medicine, or a pastille. These must be taken after you have completed your mouthwashes.

ANTI-VlRALS
You could also be susceptible to viral infections such as Herpes Simplex (cold sores). If you do develop cold sores, let the doctor/nurse know, and they will prescribe anti-viral medication. Symptoms of viral infections include a tingling and itching in one area. The area will then become red and swollen and may be painful.

If you are having problems with eating and drinking, please let the doctor/nurse know. Food supplements can be supplied until you are able to eat properly again. The dietician may also be able to advise you on foods that you could manage until your mouth feels better.

If your mouth does not seem to be getting better on the medication you have been given by the Doctor, please let the staff know, as we may be able to give you something else which will be more effective.


GENERAL TIPS FOR A SORE / DRY MOUTH
Suck sweets, e.g. Starburst. Be careful with boiled sweets in case they cut your mouth.

Avoid spicy, acidic or salty foods.

Use plenty of fluids, e.g. gravy, sauces, melted butter / 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 or alcohol.

Avoid wearing dentures.