Managing Mouth Sores

Mouth sores (also known as mucositis or stomatitis) may occur during cancer treatment in spite of the best oral hygiene.

Chemotherapy and radiation affect the cells in the body that replicate the fastest and are the most sensitive. These cells are located throughout the lining of the gastrointestinal (GI) tract, which consists of the mouth, throat, esophagus, stomach, intestines and rectum.

As a result, cancer patients often experience side effects in these areas including mouth sores and dry mouth. It is important to manage these symptoms effectively and to be aware of the proper foods that can help make sure patients still get the nutrition they need.

 

Managing Mouth Sores & Dry Mouth

  • See your dentist, if possible, before you start treatment.
  • Check your mouth daily for any sores, white patches or bleeding. Make sure to look at your teeth, gums and mucous membranes. Call your physician with any increase in sores or pain, white patches, or if you are having difficulty eating, drinking, swallowing or talking.
  • Use a soft bristle toothbrush (running under hot water can make bristles even softer) to gently brush your teeth and tongue, twice a day. Air dry your toothbrush before putting it away to discourage growth of bacteria.
  • Gently floss your teeth daily if your platelet count is in a safe range (and if advised by your MD).
  • Rinse your mouth four times a day using a bland rinse of water, baking soda and/or salt water after meals. Room temperature or cold water is usually best. (Baking soda reduces acidity of saliva, thins mucous, and discourages growth of yeast) DO NOT SWALLOW.
  • Avoid mouth products containing alcohol, as they will dry out and irritate your mouth.
  • Protect your lips using a water-based moisturizer.
  • Avoid alcohol and tobacco, which will irritate and dry out your mouth.

 

Nutritional Suggestions

  • Stay hydrated and drink plenty of fluids. Sip on fluids throughout the day.
  • Avoid foods that are salty, spicy, acidic (might consider an alkaline diet), and rough or coarse in texture.  Consume foods at room temperature.
  • Use sauces, liquid, broth, or gravy to moisten food.
  • Consume soft foods such as soups, shakes, smoothies, yogurt, hot cereals, casseroles, eggs, tender meats, and well-cooked and mashed fruits and vegetables.
  • Use ice chips, sugarless gums and sucking candies to moisten mouth.
  • For dry mouth, without mouth sores, try a tart liquid or food (lemon, lime, pickles).
  • Drink fluids through a straw to divert away from painful areas.
  • Discuss with your physician if you feel that you need medication to help alleviate the pain.
  • Your medical team may recommend liquid nutritional supplements if you are unable to consume adequate nutrition.

Always communicate with your doctor and nurse about what you are experiencing. Contact your MD if you have mouth sores, ulcerations, bleeding, white patches, pain, or difficulty swallowing, eating, drinking, or talking.

Jessica Iannotta, MS, RD, CSO, CDN

Jessica is a registered dietitian and certified specialist in oncology nutrition (CSO). She studied nutrition at Cornell University and completed her dietetic internship at New York Presbyterian Weill Cornell Medical Center. She obtained her Master's degree through the University of Medicine and Dentistry of New Jersey. Jessica has worked in inpatient and outpatient oncology settings since 2001 in the North Shore-LIJ Health System. Jessica is in charge of all operations including clinical and culinary operations ranging from menu development to evidence-based website content, relationships with registered dietitians and social workers and developing processes and protocols for intake, management and outcomes analysis of patients.

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