Mouth Care

During and following chemotherapy and/or radiotherapy treatment (to the head and neck region) your mouth needs extra care and attention. During treatment it is important to check your mouth daily. The aim of this information is to help you, and those close to you, care for your mouth during treatment. This information sheet will give you tips on how to look after your mouth.

If you are having chemotherapy and radiotherapy at the same time you are more likely to experience a sore and dry mouth. It is common for your saliva to become very thick or disappear during treatment, the care listed below will help to keep your mouth moist and minimise damage.

It is strongly advised that you see a dentist before chemotherapy or radiotherapy begins and that you continue to see your dentist regularly following treatment.

It is strongly recommended that you stop smoking during your treatment.  Smoking tobacco can increase mouth soreness and reduce the effectiveness of your treatment. We appreciate that stopping smoking may be difficult for you. Please ask your treating team for assistance in stopping smoking.

How should I care for my mouth during and after chemotherapy or radiotherapy?

 

You should start mouth care at the beginning of your treatment to minimise side effects. Mouth care requires you to:

  • inspect your mouth at least once a day

  • use a small torch or a bright light and look in your mouth by standing in front of the mirror

  • look for any sores, ulcers, pimples, red areas, white patches, or bleeding

  • gently brush your teeth and tongue using a soft bristled or electric toothbrush after each meal and at bedtime

  • use a toothpaste that contains fluoride without tartar control; ask your dentist or pharmacist for more information

  • if you have always flossed your teeth continue to do so. If you have not previously flossed do not start during treatment

  • you should replace your toothbrush/toothbrush head regularly to minimise infection risk

  • rinse your mouth after brushing and flossing using a mouthwash given to you by the hospital otherwise use a warm salt water or sodium bicarbonate mouth rinse, such as

  • 1/2 teaspoon of salt to one glass (200mL) water OR

  • 1 teaspoon of sodium bicarbonate (baking soda) to one glass (200mL) water

  • if using a shop bought mouthwash, ensure that it does not contain alcohol, as alcohol can sting, irritate and dry out your mouth. Speak to your pharmacist about an alcohol free mouthwash

For patients receiving radiotherapy to the head and neck region:

  • alcohol free Difflam mouthwash or applying xylocaine viscous is recommended, as this contains a painkiller and may be used before each meal to help make easting easier

  • keep your lips moist by frequently applying lip balm , Vaseline or soft paraffin

How should I care for mouth if I have dentures?

If you wear dentures:

  • clean your dentures thoroughly after every meal and at night with a toothbrush or denture brush. Not cleaning dentures, can cause an infection of the mouth, bad breath and soreness

  • do not wear your dentures to bed

  • leave your dentures out as often as possible during the day and whenever you use a mouthwash

  • soak dentures in warm water or a denture cleaner when not being worn

  • at first sign of discomfort or if your dentures become loose, dentures should be removed and checked by a dentist as adjustment or relining may be required

What should I do if my mouth becomes sore and painful?

If your mouth becomes too sore to brush your teeth, there are some things you can do to help your mouth feel better. Please inform your treating team if this is the case.

  • continue to rinse your mouth well after every meal using either the mouthwash you make at home or a prescription mouthwash

  • take regular pain relieving medicine as advised by your doctor

  • if you wear dentures and your mouth becomes sore, leave your dentures out and only use them for meals

  • modify your diet to soft foods or liquid to reduce pain when eating

  • avoid spicy foods and alcohol as they may irritate your mouth

  • if you are finding it increasingly difficult to eat inform your treating team as they will be able to assist you with pain control and may refer you to see a dietitian

What should I do if my mouth becomes dry?

  • take frequent sips of water or suck on ice blocks

  • use a water spray bottle to wet your mouth

  • chew sugarless chewing gum

  • suck sugarless lollies

  • moisten foods with gravies & sauces

  • avoid coffee, alcohol and soft drinks which may cause further dryness and speed up tooth decay

  • artificial saliva sprays or dry mouth gels are available that may temporarily relieve the dryness. Ask your pharmacist for more information 

What do I do if I develop bleeding in the mouth?

  • tell your treating team

  • if the bleeding is not controlled go to your nearest hospital and emergency department

  • apply pressure to the site of bleeding using a piece of clean gauze dipped in ice water

  • rinsing your mouth with ice water may also be helpful

What happens if I develop an infection in my mouth?

  • inform your treating team if you develop sores, ulcers, white patches in your mouth or on your tongue

  • if you develop an infection in your mouth, antibiotics may be needed. Your doctor will decide the best treatment depending on what type of infection you may have

Please let your treating team know if you develop the following:

  • ulcers, sores or white patches in your mouth

  • bleeding gums

  • difficulty swallowing

  • difficulty opening your mouth

  • pain

  • inability to eat or drink

  • signs of infection- temperature, chills, feeling unwell

It is important to continue regular mouth care for a few weeks after you have completed treatment