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Mouth Sores
Mouth sores (known as oral mucositis) are small cuts or ulcers that form in the lining of the inside of the mouth (the mucous membrane) and can affect the gums, tongue, roof of the mouth, or lips. Mouth sores sometimes begin as mild pain or burning, followed by white patches that may become large red lesions. Pain may range from mild discomfort to severe, making it difficult to talk, eat, or swallow. Also, infection may develop if bacteria enter into the open sores.
Mouth sores are most likely to occur in individuals who have radiation therapy in the head and neck area or receive certain chemotherapy drugs. People who receive high-dose chemotherapy with bone marrow transplant are also at high risk for mouth sores.
The cells of the mucous membranes of the mouth divide rapidly (as do cancer cells), thus possibly becoming damaged by chemotherapy and radiation therapy.
Mouth sores are short-term effects. Chemotherapy-related mouth sores usually develop within 1 to 2 weeks after treatment begins and heal within 2 to 4 weeks after chemotherapy ends.
Mouth sores caused by radiation usually develop 2 to 3 weeks after the start of radiation therapy, and it may take 6 to 8 weeks for them to heal.
Managing mouth sores involves taking steps to prevent them, to minimize pain or discomfort if they do occur, and to help them heal. It is important to take good care of your teeth and gums, including brushing and flossing several times a day. If you have poor oral health, you may want to visit your dentist before you begin treatment to help get your gums and teeth healthier.
If you will receive a chemotherapy drug with a high likelihood of mouth sores, your doctor may recommend that you suck on ice chips during the first half-hour of your treatment. This will reduce the risk of mouth sores because the cold limits the amount of the drug that reaches your mouth. Intravenous medication may be used before high-dose chemotherapy and bone marrow transplant to prevent mouth sores.
If mouth sores develop, your doctor may suggest rinsing your mouth with special solutions or may prescribe a medication that coats the lining of your mouth or pain medications that can be topically applied.
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Check your mouth 2 times per day
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Use a small flashlight and tongue blade
If you wear dentures, remove them and look under the plates
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Perform mouth care 30 minutes after eating and every 4 hours
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Brush your teeth gently with a soft nylon bristle toothbrush; if using a toothbrush is painful,use a soft foam swab (available at drug stores) or a Popsicle stick with gauze wrapped around it
Use a nonabrasive toothpaste or solution of 1 teaspoon baking soda in 2 cups water
Keep lips moist with K-Y jelly or lip balm
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Soak the toothbrush in hot water if you need to soften the bristles
Avoid toothpastes that contain additional ingredients such aswhiteners
Do not use Vaseline because the oily base may promote infection
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Avoid products that may dry or irritate the mouth
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Examples: mouthwashes that contain alcohol; lemon or glycerin swabs
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Follow diet habits to minimize discomfort and promote healing
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Drink a large amount of fluids for 2-3
quarts per day)
Use a straw to avoid mouth sores while
drinking
Eat soft foods, cut in small pieces
Eat foods at room temperature or slightly
warm
Avoid the following:
Hot, spicy, greasy, or fried foods
Very salty or high-sugar foods
Sharp or crunchy foods
Citrus fruits and juices
Alcohol, caffeine, and carbonated
beverages
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Examples: crusty breads, crackers, raw vegetables, potato chips, tortilla chips, and pretzels
Examples: oranges, limes, grapefruits, lemons, tomatoes
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Do not use tobacco
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Examples: cigarettes, cigars, pipes, chewing tobacco
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Take special precautions with dentures
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Remove and clean dentures between meals regularly
Do not wear loose-fitting dentures (they may irritate the mouth and gums)
Do not wear dentures if mouth sores are severe
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Use an antibacterial soak when cleaning
Dentures may become loose if you lose weight
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Talk to your doctor about the risk of mouth sores for the type of treatment you will receive. Call your doctor or nurse when you first notice any type of sore in your mouth. The sooner you treat mouth sores, the better chance you have of preventing them from becoming severe.
- American Cancer Society: www.cancer.org, Coping with Physical and Emotional Changes: Mouth Sores
- Oncology Nursing Society: www.cancersymptoms.org, Mucositis
- National Cancer Institute: www.cancer.gov, Management of Oral Complications During and After Chemotherapy and/or Radiation Therapy: Mucositis
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