“Chemo mouth” describes oral side effects during cancer treatment, particularly chemotherapy. These temporary changes are common complications that can significantly affect comfort and the ability to eat, drink, and speak.
How Chemo Mouth Appears
Oral mucositis, a frequent manifestation of chemo mouth, involves inflammation and sores or ulcers on the mucous membranes lining the mouth and throat. These painful lesions make eating, swallowing, and talking difficult. Mucositis typically appears about seven days after chemotherapy begins, reaching its peak around days 10 to 14, and usually resolves within a few weeks after treatment concludes.
Xerostomia, or dry mouth, results from reduced saliva production. Saliva is important for keeping the mouth moist, aiding in digestion, and maintaining oral hygiene by washing away food particles and acids. A dry mouth can lead to a sticky sensation, difficulty with chewing and swallowing, and an increased risk of dental problems like tooth decay and gum disease.
Dysgeusia, or taste changes, is also common. This can involve a metallic, bitter, or unpleasant taste, or a dulling of taste perception. These alterations can affect appetite and make eating less enjoyable.
Chemotherapy’s weakened immune system increases susceptibility to oral infections. Oral thrush, a fungal infection (candidiasis), is a common example, appearing as white or red patches in the mouth and on the tongue. Such infections can cause burning pain, alter taste, and contribute to overall oral discomfort.
Why Chemotherapy Affects the Mouth
Chemotherapy targets rapidly dividing cells, characteristic of cancer. However, this also affects other fast-growing cells, like those lining the mouth and gastrointestinal tract. This non-specific targeting leads to damage to the healthy cells in the oral mucous membranes and salivary glands.
Chemotherapy damage inhibits new cell growth, preventing oral tissue repair. This disruption in cell regeneration contributes to the development of mouth sores and other oral complications. Additionally, chemotherapy can upset the natural balance of bacteria in the mouth, shifting it towards harmful pathogens and making the oral environment more prone to problems.
Chemotherapy suppresses the immune system by reducing white blood cells, crucial for fighting infections. This immune suppression leaves the mouth more vulnerable to bacterial, viral, and fungal infections that can worsen existing oral issues or create new ones.
Strategies for Oral Care
Consistent oral hygiene helps manage chemo mouth symptoms. Gently brushing teeth with a soft-bristled toothbrush at least twice a day, and preferably after every meal, helps keep the mouth clean without causing further irritation. Regular rinsing with non-irritating solutions, such as a mixture of salt and baking soda in warm water, can help cleanse the mouth and soothe discomfort. It is important to avoid mouthwashes that contain alcohol, as these can dry and irritate the oral tissues.
Dietary adjustments can also provide relief. Consuming soft, bland foods that are easy to chew and swallow can minimize irritation to sore areas. Avoiding acidic, spicy, rough, or very hot foods and drinks is often recommended, as these can exacerbate pain and discomfort. Adding gravies or sauces to moisten meals can make swallowing easier, and eating chilled foods like popsicles or ice chips may offer soothing relief.
Managing dry mouth is crucial; frequent sips of water help keep the mouth moist. Sucking on sugar-free candies or chewing sugar-free gum can stimulate saliva flow, while artificial saliva products or sprays can provide temporary moisture. Using a lip balm regularly helps prevent dry, cracked lips.
Pain management strategies may include over-the-counter pain relievers or prescription mouth rinses and gels. Topical anesthetics can be swished and spit out, or applied directly to painful areas to provide localized numbing. For severe pain, stronger medications might be prescribed by a healthcare provider. Always consult the oncology team or dentist for severe or persistent symptoms, new sores, or signs of infection (like fever or white patches) to ensure appropriate intervention and prevent complications. Prior dental check-ups before starting chemotherapy can also help address existing issues and reduce the risk of future complications.