Chemocare.com

Care During Chemotherapy and Beyond

Dry Mouth



Other terms for dry mouth:  xerostomia

What is dry mouth?

Dry mouth (xerostomia) can be a troubling side effect and can be caused by a number of factors that persons being treated for cancer can be exposed to such as: 

  • Medications:  Chemotherapy, pain medications, anti-depressants, diuretics (water pills).
  • Radiation therapy can cause dry mouth when the salivary glands have been exposed to radiation.  The salivary glands produce saliva - the moisture in your mouth or spit.   Sometimes, over a period of time, the salivary glands will start to work again but they rarely return to normal function.  Dry mouth caused by radiation to the salivary glands can be a life long problem.
  • Conditions such as dehydration, or fungal infection of the mouth (candiasis) may lead to xerostomia.

Treating dry mouth may be treating the underlying cause such as dehydration or infection.  In cases where medications that can cause dry mouth and the benefits of taking the medication outweigh the side effects - measures to relieve the dry mouth symptom are used.  Dry mouth caused by damage to the salivary gland may be a life long problem and requires patience for treating.  There are many treatments that may assist in alleviating xerostomia and many of these can be tried on your own.

Things you can do for treating dry mouth:

Keep mouth and lips moist:

  • Rinse mouth with water frequently (every 2 hrs while awake & when awake during the night). May add salt or baking soda (1/2 to 1 teaspoon in 8 ounces of water).
  • Use saliva substitute (commercially available).  
  • Biotene® products can be purchased without a prescription.  Products available for treating dry mouth are; mouthwash, toothpaste, as well as, chewing gum that has the pH of saliva.  
  • Oralbalance® moisturizing gel can be applied to the mouth or tongue and acts as a moisturizing coat.
  • Apply lip moisturizer often (i.e. Chapstick®).
  • Suck on tart hard candies (lemon drops, Jolly Ranchers®). Watch sugar content with candy - can produce cavities.
  • Use cool mist room humidifier at night in the bedroom.  A humidifier on the furnace doesn't  provide enough humidity for treating dry mouth.

Keep mouth & teeth clean

  • Use soft-bristle toothbrush (can soften even more by placing brush in very warm water), cotton swabs, mouth swabs (popsicle stick covered with gauze) to clean teeth after each meal and at bedtime.  (3 or more times a day). 
  • Clean dentures and/or bridge after eating. Leave out dentures if experiencing any discomfort caused by xerostomia.
  • Floss gently with unwaxed floss (if platelet count not too low).
  • May use Water-Pik®
  • Avoid mouthwashes with alcohol base.  Use non-alcohol based mouthwashes. 
  • Avoid lemon glycerin swabs  - contribute to dryness.

Increase fluids:

  • Drink plenty of liquids at least 8-12 glasses of fluid a day, unless advised not to by your doctor.  This helps to thin and loosen mucous.
  • Carry a water bottle with you and sip frequently during the day to help alleviate dry mouth. 
  • Limit coffee, tea and alcohol.  These contribute to dry mouth.  Caffeine products as coffee, tea and colas act as diuretics.
  • Try Ovaltine® and Postum® drinks - each has calories and vitamins - as a substitute for tea and coffee.

Diet:

  • Eat a soft, high protein moist diet.
  • Substitute moist fish, eggs, cheese for red meat.
  • Serve food lukewarm, hot food can burn mouth.
  • Avoid dry foods (bread, dry meat, pastries, toast and crackers, snack foods that are dry and salty).
  • Soak bread and or rolls in milk or sauces.
  • Eat moistened casseroles and meats with gravies, sauces, soups, stews.
  • Use sour cream, and half & half cream as sauce bases (adds calories).
  • Avoid citric foods, juices such as tomato, orange, grapefruit based products and sauces.
  • Blenderize food and drink.
  • Yogurt, fresh fruit, powdered milk
  • Fruit slushies
  • Milk shakes with or without fresh fruit.
  • Avoid sodas that are fizzy.  May try letting the soda go flat and then drink.
  • Milk is high in protein but may produce thick saliva.  If this is true for you try soy or rice milk.

Medications that may be prescribed by your health care provider for treating dry mouth:

If dehydration is present then treating of the condition leading to dehydration such as nausea, vomiting or diarrhea would be in order.  Depending on the degree of dehydration, your doctor may recommend intravenous (IV) fluids.  Sometimes this may be done as and outpatient.  In severe cases, hospitalization could be required.

If dry mouth is due to infection, medications for treating the infection may be prescribed such as: 

  • Antifungals: nystatin,clotrimizole, fluconozole
  • Antibacterials:  Mouthwash antiseptic, rinses are the basis of the oral decontamination regimen.
  • Antivirals: acyclovir (Zovirax®) or famciclovir (Famvir®)
When to call your doctor or healthcare professional:
  • Temperature greater than 100.5 F (38 C).
  • Nausea (interferes with ability to eat and unrelieved with prescribed medication).
  • Vomiting (vomiting more than 4-5 times in a 24 hour period).
  • Diarrhea (4-6 episodes in a 24-hour period).
  • Unable to eat or drink for 24 hours or have signs of dehydration: tiredness, thirst, dry mouth, dark and decrease amount of urine, or dizziness.
  • Pain or any sign of infection (such as heavily coated tongue).

Always inform your health care provider if you experience any unusual symptoms.

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website about dry mouth, xereostomia and other medical conditions is meant to be helpful and educational, but is not a substitute for medical advice.