HF 4494

Cancer Treatment Related Mouth Sores "Mucositis

Chemotherapy and radiation therapy not only kill cancer cells, but also other fast-growing cells. Some of these cells are in the mouth, throat, and esophagus. Cancer treatment mouth sores, called mucositis, can develop after you receive treatments.


When your symptoms start will depend on your treatment. With proper care, symptoms will go away. The healing process will vary for each patient. Please discuss any symptoms with your nurse or doctor. Your symptoms may include:

  • Soreness, burning or pain in the mouth or throat

  • Red, shiny, or swollen mouth and gums

  • Sores in the mouth, on the gums or on the tongue

  • Soft, white patches or pus in the mouth or on the tongue

  • Increased mucus or thicker saliva in the mouth

  • Dryness in the mouth


Symptoms after radiation to the head, neck or chest begin about week 3 of treatment. They can last 4-6 weeks after treatment ends.


Symptoms begin within 1 week after chemotherapy is given. They improve as you recover, often 10-14 days after last dose of chemotherapy.

Bone Marrow Transplant

Symptoms begin 1 week or less after chemotherapy is given. They improve as your white blood cell count returns

Oral Care

  • One of the best things you can do to manage your mucositis is to perform good oral care. This means you should:

  • Check your tongue and mouth each day for redness, sores or white patches. If you wear dentures, remove and look at the tissue under the dentures. Report any changes to your doctor or nurse.

  • Rinse your mouth before and after meals and at bedtime (or every 4 hours if not eating often). If you have thick saliva rinse more than that.

  • Swish, gargle and spit for 30 seconds with one of these solutions (if not able to tolerate, you may use regular tap water):

    • Salt and baking soda: Mix ¼ tsp of salt and ¼ teaspoon of baking soda in an 8-ounce glass of warm water.

    • Salt and water: Mix ¼ tsp of salt in 8-ounce glass of warm water.

  • Brush teeth at least 2 times a day with a soft toothbrush. Good times to brush are after meals and before bed.

  • Use a gentle fluoride toothpaste such as Biotene or Sensodyne. Avoid products with whitening agents.

  • Floss gently if this has been part of your normal routine and if your blood counts are not too low. Ask your doctor or nurse if you can floss.

  • Replace your tooth brush every 1-2 weeks.

  • Keep lips moist by applying water or petroleum-based moisturizers.

  • Avoid things that may irritate the gums such as mouthwash or rinses that contain alcohol or peroxide.

Denture Care

  • Remove dentures whenever you can to expose the gums to air.

  • Avoid wearing loose fitting dentures or wearing dentures when mouth sores are severe.

  • Try wearing your dentures only at mealtime.

Dental Work or Surgery

Talk to your doctor or nurse before you have oral surgery or dental work done.

Diet Changes

  • Change your diet to decrease pain.

  • Eat soft foods (soup, oatmeal, jello, puddings, etc.) or moisten foods with gravy or sauces.

  • Take frequent sips of water or other caffeine-free drinks.

  • Avoid hot, spicy, acidic or rough-textured foods (potato chips, toast, etc.)

  • Avoid alcohol and carbonated drinks.

  • Avoid tobacco products.

  • Ice chips and popsicles can be soothing.

  • Eat smaller more frequent meals.

  • Include foods high in protein.

  • Consider nutritional supplements like Ensure® or Boost®.

Pain Medicine

Ask your doctor or nurse if pain medicine could help you manage the pain.