Mouth Care Chemotherapy:
Mouth care means keeping your teeth, gums and mouth clean. Mouth problems can be caused by the chemotherapy or radiation treatments you are receiving. These problems are not pleasant, but they are common. Mouth problems may begin 5 to 7 days after your treatment. It may last a few days or longer. The purpose of this sheet is to HELP YOU PREVENT or REDUCE mouth problems during treatment. There are many helpful hints below.
Steps to provide good mouth care:
- Brush your teeth and gums as you normally would.
- Use a soft toothbrush (or a foam toothette) to prevent sore gums and bleeding. Use toothpaste for sensitive teeth to brush your teeth if normal toothpaste bothers you.
- Rinse your mouth at least 4 times daily (after meals and bedtime). You can use baking soda or salt and water solution. (Mix 1 teaspoonful of baking soda or salt into 1 cup (250mL) of water—alternatively, use decarbonated club soda-). You may also use a commercial mouthwash (e.g. Biotene®), but DO NOT use products which contain alcohol (such as Listerine® or Scope®) because the alcohol will worsen pain if there are any open sores. Your pharmacist or nurse can help you choose a good mouthwash product.
- Brush and rinse your dentures after eating. Have loose dentures adjusted. Remove your dentures while sleeping.
- If you have a sore throat, severe mouth sores, chills or a temperature over 38o C or 100o F, phone your doctor.
Note: These problems are temporary and will disappear after treatment stops. It is important to have a check-up with your dentist before beginning treatment. If you have any dental problems, these may become worse and may lead to infection without proper dental care. Avoid alcoholic beverages and tobacco. These can worsen mouth sores. Try to limit exposure to the sun. Sun can make cold sores and dry lips worse. If you are going to be in the sun longer than 10-15 minutes, use a sunblock lip balm (with sunscreen, 15 SPF or higher). Avoid sunscreens with PABA. Wear a hat and sunglasses.
Indications and treatments
- See a dentist for a check-up before beginning therapy.
- Use a soft toothbrush or toothette.
- Rinse your mouth after eating before bed and first thing in the morning.
- Brush your teeth, gums, and tongue regularly.
- Have loose dentures adjusted.
- Remove dentures when sleeping.
- Tell your doctor or nurse about your sore mouth. Your doctor may order medications to help prevent infections.
- Phone your doctor if temperature over 38oC or 100oF.
- A toothette or cotton swab may be gentler than a toothbrush.
- If you usually floss, use unwaxed dental floss once a day gently, or stop temporarily.
- Limit hot, spicy, rough, acidic foods if you have a sore mouth.
- Rinse every 2 hours during the day and first thing in the morning.
- Avoid commercial mouthwashes containing alcohol Ask your doctor, nurse or pharmacist to recommend a mouthwash which is alcohol free.
- Try soft foods or liquids; food supplements may be used.
OTHER MOUTH CARE PROBLEMS Cold Sores
- Try to limit stress and sunlight exposure
- Use baking soda or salt and water rinses
- Wash your hands often and keep them away from your mouth
- Keep your lips dry.
- Usually lasts 3-10 days.
- Your doctor may order a special ointment.
- Sore Throat
- Gargle with baking soda and water or salt water rinses
- Limit hot, spicy, acidic foods.
- Drink plenty of fluids.
- Phone your doctor if you have difficulty swallowing or temperature over 38oC or 100oF. Dry Mouth
- Hard, sugar-free candy or gum may help.
- Spray water in your mouth to help keep it moist.
- Sucking on ice cubes may help • Rinse your mouth every 2 hours.
- Add bland (non-spicy) gravy and sauces to foods; avoid alcohol and tobacco.
- Ask your doctor or pharmacist about artificial saliva or other products to moisten the mouth. Dry Lips
- Drink plenty of fluids.
- Use lip balm or Vaseline® to keep your lips moist.
- Avoid licking your lips. Bad Breath
- Brush your teeth and tongue often.
- Rinse your mouth with baking soda and water rinses or Hydrogen Peroxide rinses (4 parts water to 1 part Hydrogen Peroxide)
- Floss regularly, but gently, if your gums are healthy.
- Have your doctor check your mouth for signs of infection.
Prepared by Hamilton Regional Cancer Centre- Patient Education Committee, in cooperation with the staff and patients at HRCC and other Cancer Centres; Revised by the Cancer Care Ontario-Professional Pharmacy Advisory Committee- Medication Information Sheets Working Group. Any comments about the contents of this sheet, please email firstname.lastname@example.org Revised: May, 2005