Everyone knows that hair loss is a common side effects of chemo and radiation -but did you know that these therapies can also wreak havoc in the mouth? Not only can cancer treatments cause severe dry mouth or xerostomia, but they can also cause oral mucositis. So WTF is oral mucositis?
Oral Mucositis (n): the painful inflammation and ulceration of the mucous membranes (mucosa) lining the mouth, gums, tongue and throat. It is a common and often painful or debilitating side effect of radiation therapy and chemotherapy. Lesions may compromise nutrition and oral hygiene as well as increase risk for local and systemic infection. (NIH; MuGard)
My very favorite Dental Oncologist, Dr. Dennis Abbott explains it like this… “Chemo and radiation cause changes in the lining of the mouth and reduce saliva production leading to mouth sores, infections and tooth decay. Ulcers and lesions can become so severe that patients often find it too painful to eat, chew or swallow and may even have to postpone or reschedule their cancer treatments because the pain becomes unbearable.”
Here’s the dealio (as my daughter always says)…
There is no “magic remedy” that will consistently prevent or treat oral mucositis. However, there are measures you can take that may help provide relief of discomfort, and help to prevent or treat infection.
So without further ado, some tips for managing oral mucositis:
Keep mouth and lips moist:
- Rinse mouth with water frequently (every 2 hrs while awake & when awake during the night). May add salt or baking soda (1/2 to 1 teaspoon in 8 ounces of water).
- Use saliva substitute (commercially available) if needed.
- Apply lip moisturizer often (i.e. chap stick). Try to use lanolin-based moisturizers and avoid petroleum-based products. Suck on hard, sugarless candies. Products containing xylotol are especially helpful.
- Keep mouth & teeth clean.
- Use soft-bristle toothbrush (can soften even more by placing brush in very warm water), cotton swabs, mouth swabs (popsicle stick covered with gauze) to clean teeth after each meal and at bedtime.
- Clean dentures and/or bridge after eating. Leave out dentures if experiencing any discomfort.
- Floss gently with unwaxed floss (if platelet count adequate).
- Use Water-Pik on a gentle setting.
- Suck on ice chips during chemo infusions.
For pain relief: Ask your doctor about these treatments you can use in your mouth:
- Bland rinses
- Mucosal coating agents like MuGard, a prescription mouth-rinse that should be used starting on the first day of chemotherapy or radiation treatment and every day of treatment thereafter.
- Rincinol is an over-the-counter rinse to help heal mouth ulcerations and has been helpful in treating mucositis in some patients.
- Caphosol is a calcium phosphate rinse available only with a prescription. Ask your doctor or dentist if it is right for you.
- Water-soluble lubricating agents, including artificial saliva
Things to avoid:
- Avoid mouthwashes containing alcohol.
- Avoid lemon glycerin swabs.
- Do not eat foods or drinks that have a lot of sugar in them. They may cause rampant tooth decay in a dry mouth.
Use these mouth rinses as a swish and spit routine, to alleviate symptoms:
- To neutralize acid and dissolve thick saliva: Combine 1⁄2 teaspoon salt and 2 tablespoons baking soda in 4 cups of water. If this is intolerable, try using 1/4 teaspoon salt and 1/4 teaspoon baking soda in 1 quart of water.
- To clean crusted mouth sores: Combine equal parts hydrogen peroxide and water or saltwater (1 teaspoon of salt in 4 cups of water). Note: Don’t use this solution for more than 2 days at a time, because it will prevent mucositis from healing.
- To prevent dry mouth and maintain oral hygiene, use four times daily: 1⁄2 teaspoon salt and 1⁄2 teaspoon baking soda in 1 cup of warm water.
Call Your Doctor If You Have These Mucositis Symptoms:
- Mouth sores that are so painful that you avoid eating or speaking
- Mouth sores that just won’t heal
- Persistent burning feeling in your mouth, throat, stomach, or digestive tract
- Fever of 100.5° F or chills with shaking