Mouth and throat problems

During your treatment for cancer your mouth may become dry or sore. Soreness or ulceration of the mouth is called mucositis and can be painful. Any damage to your mouth will usually be temporary and your mouth will get better over time.

Radiotherapy or chemotherapy may damage the saliva glands temporarily, so your mouth may become dry.

You can make small changes to the food and drinks you have to improve these side effects. Drinking plenty of water or non-acidic fruit juices, such as peach nectar can help.

Other tips include: Adding ice to drinks and eating cold food, which is more soothing than hot drinks and food; keep your food moist with sauces and gravies; and cleaning your mouth with a soft brush.

If these changes don’t help your symptoms, you can talk to your doctor about your mouth problems. They can prescribe mouthwashes, sprays or painkillers if needed.

If you have a sore mouth

Soreness and ulceration of the lining of the mouth or throat is called mucositis and can be very painful. It can be caused by chemotherapy, targeted therapies, and radiotherapy to the head and neck. Damage to the cells lining the mouth or throat is usually temporary and most side effects will go when treatment ends.

Your specialist nurse and doctor will talk to you about mouth care during treatment and they may examine your mouth from time to time. Tell them if your mouth is sore or if it getting worse.

Tips to help keep your mouth healthy:

  • Drink plenty of fluids, especially water. If you find that fresh fruit juices sting your mouth, try less acidic juices instead. For example, you could try peach or pear nectar and blackcurrant or rosehip syrup. Some pre-prepared drinks that taste like fruit juice may also be helpful. These are available from health food shops and some supermarkets. Try milk or milk-based drinks, such as malted drinks, milk shakes and hot chocolate.
  • Cold foods and drinks may be more soothing. Try adding crushed ice to drinks and eating ice cream or soft milk jellies. Some people find sucking on ice soothing.
  • Very hot or cold drinks may irritate your sore mouth so try having drinks that are lukewarm or at room temperature.
  • Try drinking through a straw.
  • Avoid salty or spicy food that may sting.
  • Avoid rough-textured food, such as toast or raw vegetables, as they can scrape at sore areas.
  • Keep your food moist with sauces and gravies.
  • Tell your doctor if you have a sore mouth. They can prescribe soothing or antiseptic lotions or sprays for you. You may also need painkillers before mealtimes to help you with swallowing.
  • Mouthwashes can be very soothing, but many available in chemists or shops may be too strong for you. Evidence shows that salt-water mouthwashes are just as effective at reducing soreness, or your doctor can prescribe an anaesthetic gel or mouthwash instead. Many hospitals have their own mouth care guidelines for people having chemotherapy or radiotherapy. Your doctor or specialist nurse will be able to advise you.
  • Speak to your dentist about support during your cancer treatment. They may recommend high-fluoride or non-foaming toothpaste to help reduce soreness.
  • Use a children’s soft toothbrush to clean your teeth gently. Avoid toothpicks when cleaning your teeth.
  • If you wear dentures, soak them in a denture-cleaning solution overnight and leave them out for as long as you can during the day to prevent them rubbing your gums. If you’re having radiotherapy to the jaw area, you may be advised to keep your dentures in as much as possible during the day to help maintain the shape of your gums. However, if your mouth is very sore, it may be more comfortable to not wear your dentures.


If you have a dry mouth

Radiotherapy to the head and neck area and some chemotherapy drugs can damage the saliva glands, and this may lead to a dry mouth (xerostomia).

Tips if you have a dry mouth:

  • If your tongue is ‘coated’ it may make your food taste unpleasant and might put you off eating. You can clean your tongue with a bicarbonate of soda solution: use one teaspoon of bicarbonate of soda (available from your chemist) dissolved in a pint (570mls) of warm water. Clean your tongue with a soft toothbrush, foamstick or gauze, dipped in the solution. Check with your clinical nurse specialist for further advice.
  • Frequent drinks, even if you just take a few sips at a time, can help keep your mouth moist. You may find fizzy drinks the most refreshing. Keep a glass of water by your bedside and carry water with you whenever you go out.
  • Try sucking ice cubes or lollies. You can make lollies by freezing fresh fruit juice in ice-cube trays or in special lolly containers with sticks.
  • Keep your food moist with sauces and gravies.
  • Avoid chocolate and pastry as they can stick to the roof of your mouth.
  • Chewing gum can sometimes stimulate your saliva.
  • Tell your doctor about your dry mouth. They can prescribe mouthwashes, lozenges, artificial saliva sprays or gels, if you think they will help.
  • Use lip balm or petroleum jelly for dry lips, but do not use any balm on your lips during radiotherapy treatment – speak to your clinical nurse specialist or radiotherapy team about this.