Ask the expert
Causes and treatments of sore mouth
Question
Why is my mouth sore?
Answer
Mouth soreness is a frequent complication of both chemotherapy and radiotherapy more specifically to the head and neck region. Chemotherapy often causes the body’s immune system to temporarily be reduced or even destroyed which then allows infections to attack areas such as the mouth. In addition, chemotherapy affects both the malignant cancer cells and all the rapidly dividing cells in the body. The lining of the mouth and in fact the entire gastrointestinal tract has rapidly dividing cells and therefore you can go onto develop inflammation and ulceration in the mouth, which causes the soreness. This is often referred to as stomatitis or mucositis. The first signs of mouth sores occur when the lining of the mouth appears pale and dry. Later on the mouth, gums, and throat feel sore and can become red and inflamed. The tongue may become coated and swollen, leading to difficulty swallowing, eating, and even talking. Mouth, throat, and even oesophageal sores are temporary and usually develop 5-14 days after receiving chemotherapy. Other alterations in the mouth include dryness (xerostomia), taste changes or a complete lack of taste.
To limit mouth infections and you may be given preventative mouthwashes to take several times a day but gargling with salty water is also of benefit. Good oral hygiene should be performed ideally every 4 hours. The teeth should be brushed gently with a soft toothbrush after meals and at bedtime. Dentures should only be warn if necessary. In addition, the use of commercial mouthwashes containing alcohol should be avoided since they can dry and irritate the mouth further. Sore mouths also can be treated with pain relieving mouthwashes, pain medications taken as oral pills, liquids, injections or infusions. Sucking on ice chips or ice pops are also helpful. Avoiding spicy, salty, sour or sharp foods and fluids is also recommended since they worsen discomfort or soreness. Oral irritants such as alcohol and tobacco should also be avoided. Preference should be put on soft moist foods. Eating pineapple chunks helps to keep your mouth fresh and moist. Dry mouth can be easily treated with drinking fluids, sodas, sucking ice chips, eating fresh fruits or chewing gum. Preparations containing alcohol or glycerine should not be used because they may irritate or worsen dryness. Artificial saliva is available on prescription, as are moisturizing mouthwashes and gels which can be useful in some patients. Dryness should be reported to your hospital doctor, GP specialist nurses or dietitian, as it may predispose to ulcers and infections.
Source: Nutrition in cancer Editorial Board
