A Guide to Chemotherapy

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Mouth, gum, tongue, and throat problems

Good mouth care is important during cancer treatment. Chemo can cause sores in the mouth and throat. It can make these areas dry and irritated or cause them to bleed. Mouth sores are not only painful, but they can also become infected by the many germs that normally live in your mouth. Infections can be hard to fight during chemo and can lead to serious problems. It’s important to take every possible step to help prevent them.

Some people notice color changes of their tongues when getting chemo. These dark spots are called hyperpigmentation. This is more common in dark-skinned people. The cause is not clear, it’s not painful or dangerous, and it goes away on its own after treatment ends.

Ways to help keep your mouth, gums, tongue, and throat healthy:

  • Have your teeth cleaned at least 2 weeks before you start chemo, and take care of any cavities, abscesses, gum disease, or poorly fitting dentures. This will give you time to heal from any procedures that are needed.
  • Ask your dentist to show you the best ways to brush and floss your teeth during chemo.
  • Ask about a daily fluoride rinse or gel to help prevent decay because chemo can make you more likely to get cavities.
  • Brush your teeth and gums after every meal. Use an extra-soft bristle toothbrush and a gentle touch – brushing too hard can damage soft mouth tissues.
  • Ask your dentist to suggest a special type of toothbrush, floss or dental ribbon, and toothpaste if your gums are very sensitive.
  • Rinse your toothbrush well after each use, and store it in a dry place.
  • Avoid commercial mouthwashes. They often contain irritants such as alcohol. Instead, ask your doctor or nurse about a mild mouthwash to help prevent mouth infections.

If you develop sores in your mouth (this is called stomatitis [STO-muh-TIE-tus]), tell your doctor or nurse right away because you may need treatment. Be sure to let the doctor know if the sores are painful or if they keep you from eating.

If the sores are painful or keep you from eating, try these tips:

  • Ask your doctor if there’s anything you can put right on the sores to treat them and if there’s medicine you can take to ease the pain.
  • Eat foods cold or at room temperature. Hot and warm foods can irritate a tender mouth and throat.
  • Choose soft, soothing foods, such as ice cream, milk shakes, baby food, soft fruits (like bananas and applesauce), mashed potatoes, cooked cereals, soft-boiled or scrambled eggs, cottage cheese, macaroni and cheese, custards, puddings, and gelatin. You also can puree cooked foods in the blender to make them smoother and easier to eat.
  • Avoid irritating, acidic foods, such as tomatoes, citrus fruit, and citrus fruit juice (orange, grapefruit, and lemon); spicy or salty foods; and rough, coarse, or dry foods like raw vegetables, pretzels, granola, and toast.

If your mouth is dry and it bothers you or makes it hard for you to eat, try these tips:

  • Ask your doctor if you should use an artificial saliva product to moisten your mouth.
  • Drink plenty of liquids.
  • Suck on ice chips, Popsicles, or sugarless hard candy.
  • Chew sugarless gum.
  • Moisten dry foods with butter, margarine, gravy, sauces, or broth.
  • Dunk crisp, dry foods in mild liquids.
  • Eat soft and pureed foods.
  • Use lip balm if your lips become dry.

Last Medical Review: 06/09/2015
Last Revised: 06/09/2015