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Dry mouth during cancer treatment

What to expect

Some cancer treatments and medicines can cause dry mouth. Symptoms you may have include:

  • Mouth sores
  • Thick and stringy saliva
  • Cuts or cracks in your lips, or at the corners of your mouth
  • Your dentures may no longer fit well, causing sores on the gums
  • Thirstiness
  • Difficulty swallowing or talking
  • Loss of your sense of taste
  • Soreness or pain in the tongue and mouth
  • Cavities (dental caries)
  • Gum disease

Take care of your mouth

  • Brush your teeth and gums 2 to 3 times a day for 2 to 3 minutes each time.
  • Use a toothbrush with soft bristles.
  • Use toothpaste with fluoride.
  • Let your toothbrush air dry between brushings.
  • If toothpaste makes your mouth sore, brush with a solution of 1 teaspoon of salt mixed with 4 cups of water. Pour a small amount into a clean cup to dip your toothbrush into each time you brush.
  • Floss gently once a day.

Rinse your mouth 5 or 6 times a day for 1 to 2 minutes each time. Use one of the following solutions when you rinse:

  • 1 teaspoon of salt in 4 cups of water
  • 1 teaspoon of baking soda in 8 ounces of water
  • ½ teaspoon salt and 2 tablespoons baking soda in 4 cups of water

Do not use mouth rinses that have alcohol in them. You may use an antibacterial rinse 2 to 4 times a day for gum disease.

Other tips for taking care of your mouth include:

  • Avoiding foods or drinks that have a lot of sugar in them that may cause tooth decay
  • Using lip care products to keep your lips from getting dry and cracking
  • Sipping water to ease mouth dryness
  • Eating sugar-free candy or chewing sugar-free gum

Talk with your dentist about:

  • Solutions to replace minerals in your teeth
  • Saliva substitutes
  • Drugs that help your salivary glands make more saliva

Diet

You need to eat enough protein and calories to keep your weight up. Ask your doctor about liquid food supplements that can help you meet your caloric needs and keep up your strength.

To make eating easier:

  • Choose foods that you like.
  • Eat foods with gravy, broth, or sauce to make them easier to chew and swallow.
  • Eat small meals and eat more often.
  • Cut your food into small pieces to make it easier to chew.
  • Ask your doctor or dentist if artificial saliva might help you.

Drink 8 to 12 cups of liquid each day (not including coffee, tea, or other drinks that have caffeine).

  • Drink liquids with your meals.
  • Sip cool drinks during the day.
  • Keep a glass of water next to your bed at night. Drink when you get up to use the bathroom or other times you wake up.

Do not drink alcohol or beverages that contain alcohol. They will bother your throat.

Avoid foods that are very spicy, that contain a lot of acid, or that are very hot or very cold.

If pills are hard to swallow, ask your doctor if it is OK to crush your pills. (Some pills do not work if they are crushed.) If it is OK, crush them up and add them to some ice cream or another soft food.

References

Jones DL, Rankin KV. Management of the oral sequelae of cancer therapy. Tex Dent J. 2012;129:461-468.

National Cancer Institute. Chemotherapy and you: support for people with cancer. http://www.cancer.gov/cancertopics/coping/chemotherapy-and-you. Accessed May 7, 2014.

Sideras K, Hallemeier CL, Loprinzi CL. Oral complications. In: Niederhuber JE, Armitage JO, Doroshow JH, et al., eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2013:chap 43.

Updated: 5/7/2014

Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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