Sore Mouth Due To Chemotherapy

Key points about sore mouth due to chemotherapy

• a sore mouth and throat are common side effects of chemotherapy treatment
• the lining of your child's mouth and throat becomes weak - this may lead to inflammation and ulcers
• good mouth care will help avoid infection and will make things more comfortable for your child
• make sure your child's toothbrush is clean and replace it every 1 to 2 months

How can chemotherapy affect my child's mouth and throat?

The lining of your child's mouth and throat becomes weak during chemotherapy treatment - this may lead to inflammation and ulcers. This is called mucositis. Mucositis reduces the desire to eat, drink and swallow. It may also lead to septicaemia (bacteria entering the bloodstream). Good mouth care will help avoid infection and will make things more comfortable for your child.

How can I care for my child's mouth during cancer treatment?

Dental care

Brush teeth using a soft-bristled toothbrush and toothpaste at least twice a day - this helps to stop plaque build-up and prevent gum disease. Make sure your child's toothbrush is clean, and replace it every 1 to 2 months.

Always tell your doctor before you make a dental appointment for your child. Before you visit the dentist, tell the dentist that your child is having chemotherapy

Lip care

Keep lips moist by using creams often, including after brushing - creams such as lanolin and soft paraffin will protect against drying and chapping.

Tell your doctor if your child is having trouble with their lips or teeth.

When is mouth soreness likely to happen during my child's cancer treatment?

Your child is likely to feel mouth soreness 7 to 10 days after chemotherapy starts. This is the time when the blood cell counts are likely to be lowest, and the lining of the mouth will be weak.

What about eating and drinking during my child's cancer treatment?

Make sure your child has a fresh, clean mouth before eating. Swishing with water or a mouthwash may be enough, or you may need to help with gentle teeth cleaning. After that, here are some ideas which may help.

Give soft moist foods

Some examples are custard and yoghurt, scrambled eggs, mornay (cheese-flavoured white sauce), mashed vegetables with butter, ice cream, pasta, custard, rice or baby food.

Keep foods moist by adding extra gravy, sauce, yoghurt, cream or butter.

Give nourishing drinks

Give nourishing drinks that your child can sip slowly.

Some suggestions:

• milkshakes - full cream milk with added ice-cream, cream or yoghurt and flavouring
• fruit smoothies - banana or strawberries blended with milk
• yoghurt smoothies - fruit juice, yoghurt and fresh fruit mixed
• supplements added to drinks - speak to your child's dietitian

Avoid rough foods and foods that might sting

Avoid giving foods that might sting, like citrus juice and very salty or spicy foods.

Avoid giving rough foods like toast and foods that may need a lot of chewing.

What are the signs my child might have a sore mouth during cancer treatment?

If your child can't tell you their mouth is sore, these are the signs to look for:

• drooling - in younger tamariki (children)
• difficulty speaking or opening their mouth
• refusing food and drink because of pain when eating
• difficulty swallowing
• dry or cracked lips
• pale, rigid gums
• redness or swelling of their gums
• bleeding gums
• mouth ulcers

How can I help make mouth care fun for my child during cancer treatment?

Involve brothers and sisters in the game of mouth care. Things you could try include:

• role play with a dolly or teddy
• use praise and encouragement - ask for kisses to smell the sweet, fresh breath
• play with the swabs, pretending to paint pictures inside your child's mouth
• encourage independence by allowing younger tamariki to hold the swab, put on the gel etc

Read more about side effects of treatment

Read more about childhood cancer