Mouth Sores/Sore Throat

Some patients may develop mouth sores (and sore throats) as a side effect from anticancer treatment. The severity of mouth sores may range from reddened areas with mild discomfort to white, ulcerated sores that are painful and require pain medication. The side effect is temporary and the mouth heals very quickly.

Patients receiving the chemotherapy agent 5FU may prevent or minimize mouth sores by chewing on ice 5 minutes prior to their treatment, through the treatment, and for 20 minutes following treatment. If your treatment is given in combination with Oxaliplatin, avoid food items that are cold, especially ice.

The following information may help minimize discomfort and promote healing of the mouth sores.

1. Keep your mouth and teeth (or dentures) clean. Brush your teeth (dentures) and tongue with a soft toothbrush and mild toothpaste 2 to 3 times daily. Do not use mouthwashes containing alcohol. If the toothbrush causes pain or discomfort, try soaking it in hot water to further soften the bristles. If still painful, use foam toothettes, which are available at most pharmacies or wrap gauze around a Popsicle(r) stick and gently swab the teeth and gums.
2. Keep lips moist with K-Y jelly or Chapstick®. Do not use Vaseline® because the oily base may promote infection.
3. Rinse and gargle at least 4 times daily with the following solution to keep the mouth clean and promote healing: 1 teaspoon of baking soda and 1 teaspoon of salt in 1 quart of water (be sure to mix this fresh daily to prevent bacteria from growing in the solution)
4. Use a pain reliever. Such as Extra-strength Tylenol (acetaminophen) 2 tablets every 6 hours (unless instructed not to use this product by your doctor or nurse). If this does not relieve your pain so you can continue to eat and drink, contact the office for advice.
5. Do not use tobacco products or attempt to drink alcoholic beverages. These products dry the mouth and throat and increase the pain.
6. You must continue to eat and drink. If you cannot eat or drink you will become weak and have greater difficulty healing and be at risk for dehydration. The following suggestions may help you to continue taking in food and fluids.

Drink eight 8-oz. glasses of fluid daily. Avoid carbonated drinks, citrus or tomato juice, spicy drinks, or extremes of hot or cold because these will increase your discomfort. Limit caffeine to two cups per day.

Drinking through a straw may be more comfortable.

Avoid foods that will increase your discomfort such as: Spicy foods (barbecue, Mexican, Chinese), and acidic type foods (citrus, tomato base, vinegar base)

Eat soft foods or semisolids such as: cooked cereals with sugar and cream, soups (especially creamed soups), eggs, pastas, tender cuts of meat, potatoes, melon, canned fruits like peaches and pears, puddings, yogurt, ice cream, milkshakes (if the cold doesn’t bother you). Include foods high in protein such as dried beans, poultry, eggs, peanut butter, meat, fish, and dairy products, such as milk, cheese and yogurt.

When Should I Call My Doctor?

Mouth sores should not be ignored, since they can cause a decrease intake of food and fluid, can be a source of infection, and can cause pain and discomfort. Call your doctor immediately if you have any one or more of the following:

• Redness, shininess, or ulcers in the mouth that lasts for more than 48 hours.
• Bleeding gums.
• Oral temperature above 100.5°F, chills or sweats.
• Weight loss of 5 pounds or more since the mouth sores began.

How are Mouth Sores Treated?

To promote healing of mouth sores, your oncologist or nurse may recommend that you rinse with special solutions.

If mouth pain is severe or interferes with eating, your oncologist may prescribe a medication, which temporarily numbs the mouth. In addition, if weight loss from poor intake of food and fluids is a concern, you may be referred to a nutritionist.

If necessary, your oncologist may decide to delay further treatments until the mouth sores have healed.

If you have any questions about mouth sores, or need additional information and direction, ask your doctor or nurse.