Chemotherapy can have many unpleasant side effects, one of which is oral Mucositis: mouth sores or ulcers that develop on the soft tissues of your lips, mouth, gums, and tongue, and, in some cases, extend into the esophagus. Not every patient will develop mouth sores from chemotherapy, but if you do, there are steps you can take to reduce the pain and heal the sores as quickly as possible.
Understanding How Mouth Sores Develop
1- Understand how chemotherapy works. Chemotherapy can be effective against cancer because it kills rapidly dividing cells. Some of these cells are cancer cells, and you definitely want the chemotherapy to kill them. Unfortunately, though, there are many normal, healthy cells that divide rapidly, including some in the mouth and throat.
Patients undergoing chemotherapy often have lowered white blood cell counts, leaving them vulnerable to infection.
2 Recognize the symptoms. Mouth sores are hard to miss. They typically start as red spots or a stinging, burning feeling in the mouth. The sores then become raised with white patches, and they may “open” – these open mouth sores are called ulcers, and they are very painful. People with mouth sores often find it painful to eat, drink, or swallow.
Mouth sores typically development a few days after a chemotherapy regimen begins. They usually last until two or three weeks after cessation of chemotherapy.
Keeping Your Mouth Moist
1- Rinse often with water. During chemotherapy, your mouth may become very dry. This side effect increases the friction between your teeth and the soft tissues of the mouth, which can cause and exacerbate mouth sores. It can help to rinse frequently with water.
- Aim to rinse your mouth with water every two hours when you are awake, plus before you go to bed. If you wake in the night, take the opportunity to rinse again.
- You may add table salt and/or baking soda to the water, which may also help alleviate your symptoms.
2- Purchase artificial saliva. If your mouth is very dry, you can buy artificial saliva over the counter in liquid or aerosol form.
3- Moisturize your lips. Buy lip balm and apply it frequently to keep your lips from drying and cracking.
Handling Oral Hygiene
1- Rinse after eating. In addition to the regular rinsing suggested above, you should rinse your mouth with water after you eat. This dislodges many food particles and prevents unnecessary irritation.
2- Brush your teeth gently. The bristles of a toothbrush may aggravate your symptoms, so use the softest toothbrush you can find or substitute a soft cotton swab. Brush as gently and carefully as you can two or three times a day. This will minimize bacteria and reduce oral ulcers.
Avoid toothpastes with whitening agents, which could irritate your mouth.
3- Stick to salt and soda mouthwashes. You can use mouthwashes made from water and salt or baking soda, but do not use standard commercial mouthwashes containing alcohol. Alcohol will dry your mouth and make your symptoms worse.
Similarly, do not use glycerin swabs or any other products containing alcohol.
4- Keep dentures clean. If you wear dentures, wash them after every meal to avoid introducing bacteria or irritants. If your dentures bother you, you may want to skip wearing them until your mouth sores have healed.
Reducing Your Pain at Home
1- Eat bland, soft foods. Avoid acidic foods. Lemons, oranges, and grapes, for example, contain high levels of citric acid, which can harm the soft tissues of your mouth and make you more vulnerable to oral Mucositis. In addition, avoid spicy foods (like hot peppers) and foods with sharp edges (like potato chips) may cause unnecessary pain.
2- Be careful with the temperature of your food. Extremely hot or extremely cold foods can damage the inside of your mouth, making your condition worse.
3- Maintain a healthy diet. Chemotherapy can make you feel very sick, but it’s important to try to eat plenty of protein and add extra calories, preferably in the form of foods that do not injure the soft tissues of your mouth.
Consider eggs, milk, dietary supplements, and puddings. Mash foods to make them soft if necessary.
4- Drink plenty of fluids. Keeping hydrated is also important. Try to drink plenty of water and other non-irritating liquids.
5- Avoid caffeine and alcohol. Both caffeine and alcohol can irritate your mouth sores and make your symptoms more painful. In addition to avoiding caffeinated and alcoholic beverages, be sure to check your medications. Many medications – both prescription and over-the-counter versions – contain alcohol.
6- Do not smoke. Smoking cigarettes harms the inner lining of your mouth (in addition to causing cancer and other health problems). If you are undergoing chemotherapy, smoking is very likely to produce and exacerbate mouth sores.
7- Try popsicles or ice cream. Warm popsicles or ice cream slightly – you don’t want them to be freezing cold – and then eat them. These may soothe your symptoms and decrease inflammation.
8- Apply vitamin E. Vitamin E contains antioxidants and will help your mouth sores heal. Apply a capsule containing 400 International Units of vitamin E directly to your mouth sores, using a cotton swab.
9- Make a homemade mouthwash treatment. Mix equal parts Lidocaine viscous solution and Acyclovir (which may be available without a prescription). Use two teaspoons every two to three hours. The Lidocaine will relieve pain, and the Acyclovir will fight viral infections related to mouth sores.
10- Buy over-the-counter medications. There are various medicines that can help with mouth sores, including those with Benzocaine, like Oral jell. These medicines may also contain Lidocaine, a pain reliever that coats and numbs affected areas temporarily. Follow the instructions on the label to reduce your discomfort by disrupting the transmission of pain signals from your mouth sores to your brain.
Treating Mouth Sores Medically
1- Ask your doctor about prescription-strength mouthwashes. Your doctor may prescribe “Mouthwash,” which is relieving pain.
2- Get intravenous fluids and nutrition. If your mouth sores become so painful that you cannot eat or drink normally, your doctor will admit you to a hospital and administer fluids and nutrients through an IV.