Mouth Care During Your Cancer Treatment

This video explains how to care for your mouth and manage mouth pain during cancer treatment.

In this video, the word “you” means either you or your child.

During your cancer treatment, you might have redness, swelling, tenderness, or sores on the lining of your mouth, tongue, or lips. This is called mucositis. Mucositis can make it hard to eat, swallow, and speak.

You might notice signs of mucositis starting about three to ten days after you start treatment. Sometimes, you might not notice signs until later.

If you have mucositis, tell your healthcare provider right away. They may prescribe a medication to help.

If your mouth is very irritated, they might refer you to MSK's dental service or your local dentist. If mucositis is making it hard for you to eat or drink, they might also recommend that you see a dietitian to make sure you’re getting all the nutrients you need.

Taking good care of your mouth can help you prevent and manage mucositis.

Gently brush your teeth and tongue with a small, soft-bristle toothbrush within 30 minutes after you eat. It's best to use a fluoride toothpaste. If your mouth is very sore, you can use a super-soft-bristle toothbrush instead of a soft-bristle one.

Change your toothbrush every three to four months, or more often if the bristles are worn.

Rinse your mouth every four to six hours, or whenever it's dry. You can use water or a mouthwash that doesn't have alcohol or sugar.

You can also make your own mouthwash by mixing one quart of water, which is four cups, with one teaspoon of salt, one teaspoon of baking soda, or both.

Swish the mouthwash in your mouth, gargle for 15 to 30 seconds, then spit it out. Use mouthwash that's at room temperature, not warm or cold.

Don't use mouthwash that has hydrogen peroxide unless your doctor tells you to.

If you need to irrigate your mouth, your nurse will tell you and give you instructions for how to do it.

It's also important to keep your lips moist. Use a lip moisturizer four to six times a day, or whenever your lips feel dry. But if you're getting radiation therapy to your head or neck, don't use a lip moisturizer within four hours of your treatment.

Every night before bedtime, brush your teeth, rinse your mouth, and moisturize your lips.

You should also floss your teeth with unwaxed dental floss if you flossed regularly before you started treatment. If you didn't floss regularly before your treatment, don't start now.

If you use a removable dental prosthesis, like dentures, it's okay to keep using it as long as it still fits and doesn't irritate your mouth.

Take it out and clean it every time you clean or rinse your mouth. If your mouth is irritated, keep it out of your mouth as much as you can. Take it out of your mouth before you go to bed.

If you aren't eating food orally, which means by mouth, you should still clean and moisturize your mouth and lips regularly.

Certain foods can cause mucositis or make it worse. It's best to avoid tobacco, alcohol, (including mouthwash with alcohol) salty or spicy foods, acidic foods and drinks (such as citrus fruits and juices) tomatoes, and tomato sauce, hard, dry, or rough foods, and hot or cold foods and drinks.

If you're having trouble swallowing, there are things you can do to make swallowing easier.

Eat small bites of moist, soft, bland foods, and chew your food well. You can use sauces and gravies, moisten foods with yogurt, milk, soy milk, or water, dip dry foods in a liquid, or blend or puree your food.

If your mouth is dry, rinse it just before eating. This will help moisten your mouth and stimulate your taste buds.

It can also be helpful to drink small sips of water or use a spray bottle to squirt water into your mouth often throughout the day. Use a mouth moisturizer, chew on special moistening gum, or suck on special moistening lozenges. You can buy moistening gum and lozenges at your local pharmacy.

Using a room humidifier can also help, especially in your bedroom.

It's important to try to eat so you get some nutrients. Try having a small meal every two to three hours instead of having a few big meals. You can also add protein powder to broths, soups, cereals, and drinks, or drink nutritional supplements.

Drinking plenty of water throughout the day is also important so you get enough liquids. Drinks with sugar in them can cause tooth decay, so don't drink too many sugary drinks between meals.

Children should follow all the guidelines we've talked about, along with the following guidelines just for children.

Children more than two years old should use a fluoride toothpaste. If your child is two years old or younger, talk to their dentist or doctor before using fluoride toothpaste.

If your child doesn't have teeth yet, use a washcloth, towelette, or sponge with water to clean their gums after they eat and before they go to bed.

If your child's immune system is stable, they should visit their dentist for routine care every six months.

To learn more about helping your child manage their mouth pain, call 833-MSK-KIDS, or 833-675-5437, to talk with Child Life Services.

If you have questions about mucositis or mouth care during your cancer treatment, you can ask your nurse, or you can find more resources on our website by visiting www.mskcc.org/pe and searching for mouth care.

You can also ask your nurse about how MSK's dental service can help you.