Mouth problems

The following tips may help keep your mouth healthy during and after cancer treatment.

• Drink plenty of fluids, especially water. If fruit juices sting your mouth, try less acidic juices instead – for example, peach or pear nectar, or blackcurrant or rosehip syrup. You could try freezing them in an ice cube tray as sucking on the ice cubes can soothe your mouth.
• Avoid fizzy drinks because these may sting your mouth.
• Try milk or milk-based drinks, such as malted drinks, milkshakes and hot chocolate. These can be from cow’s milk, goat’s milk or a plant-based alternative such as soya, rice or oat milk.
• Cold drinks may be soothing – try adding crushed ice to drinks.
• Very hot or very cold drinks may irritate a sore mouth. Some people find drinks that are lukewarm or at room temperature more soothing.
• Try drinking through a straw.

• Avoid salty or spicy food.
• Avoid rough-textured food like toast or raw vegetables.
• Keep your food moist by adding sauces and gravies.
• Cold foods may be soothing – try eating ice cream or soft, milk jellies.
• You may find that taking painkillers before meals can help you swallow more easily.

Keeping your mouth as clean as possible during your treatment will help to prevent or reduce side effects in your mouth.

Using a mouthwash

Mouthwashes can be very soothing, but many of the ones available in chemists or shops may be too strong for you.

Salt water mouthwashes can help reduce soreness, if it is not too severe. To make the mouthwash, add 1 teaspoon of salt to cold or warm water. Rinse this around your mouth. Then spit it out and then rinse your mouth with cold or warm water.

Your doctor can prescribe an anaesthetic gel or mouthwash to help if needed.

Looking after your teeth or dentures

Many hospitals have their own mouth care guidelines for people having chemotherapy or radiotherapy, which include the best toothpaste to use. Your doctor or specialist nurse will be able to advise you.

You may be advised to see your dentist before you start treatment. They may recommend using a high-fluoride or non-foaming toothpaste to help reduce any soreness.

Use a soft toothbrush to clean your teeth gently. Avoid using toothpicks when cleaning your teeth. If you want to use dental floss, check with your doctor or specialist nurse first. If you have a low platelet count, flossing can make your gums bleed.

If you wear dentures, soak them in a denture-cleaning solution overnight. Leave them out for as long as you can during the day to prevent them rubbing against your gums.

If you are having radiotherapy to the jaw area, you may be advised to keep your dentures in as much as possible during the day. This helps to maintain the shape of your gums. But if your mouth is very sore, it may be more comfortable to leave your dentures out.

If your tongue is ‘coated’

This may make your food taste unpleasant and put you off eating. You can clean your tongue with a bicarbonate of soda solution. Dissolve 1 teaspoon of bicarbonate of soda (available from your chemist) in a pint (570mls) of warm water. Use a soft toothbrush or gauze dipped in the solution to clean your tongue.

If this does not help, talk to your doctor or specialist nurse, because you may have oral thrush and need medicine. If you are having radiotherapy for a head and neck cancer, brushing your tongue is not recommended. Your clinical nurse specialist can give you more advice.

You may find that food tastes different during treatment. This is usually temporary, but sometimes it can be permanent. You may no longer enjoy certain foods, or you may find that all food tastes the same. Food may taste very sweet or salty. Or you may have a metallic taste in your mouth or find that things taste like cardboard. You may lose your sense of taste, but it usually comes back.

The following tips may be helpful for coping with taste changes:

• Try different foods to find out what tastes best to you. Keep trying different foods as your taste changes.
• Eat foods that you enjoy and ignore those that do not appeal to you. But try them again after a few weeks, because your sense of taste may have changed.
• Use seasonings, spices and herbs such as pepper, cumin or rosemary to flavour your cooking. But if your mouth is sore, you may find that some spices and seasonings make it worse.
• Try eating bland foods such as bread, potatoes and crackers.
• Try marinating meat.
• Cold meats may taste better served with pickle or chutney.
• Sharp-tasting foods can be refreshing and leave a pleasant taste in your mouth. These include fresh fruit, fruit juices and sugar-free sour or boiled sweets. Be careful if your mouth is sore as these may be painful to eat.
• If you no longer like tea or coffee, try lemon tea, herbal teas or a cold drink such as lemonade.
• Some people find that cold foods taste better than hot foods. If your sense of taste or smell changes, it may help to let your food cool before eating it.
• Serve fish, chicken, red meat and egg dishes with sauces. You could add these sauces to vegetables too. But be careful if your mouth is sore as some sauces, such as curry or sweet and sour, may feel painful to eat.
• If you notice a metallic taste in your mouth, try using re-usable plastic cutlery.
• Brush your teeth before meals.