Mouth Sores due to Chemotherapy
Other terms: mucositis, stomatitis, esophagitis, sore mouth
What is mucositis (mouth sores) and what is its relationship to chemotherapy,
radiation, and other cancer treatments?
Mucositis is an inflammatory reaction of the mucous lining of the upper gastrointestinal
tract from mouth to stomach (mouth, lips, throat) and surrounding soft tissues.
- Stomatitis refers to inflammation in the mouth.
- Esophagitis refers to inflammation of esophagus.
- Mucositis refers to all mucous linings.
This response is due to certain chemotherapeutic drugs,
biologic response modifiers, radiation therapy, and/or surgery. This reaction may
progress to painful ulcers and infection, interfering with eating, talking, taste,
chewing or swallowing and often lasting a few days.
Mucositis is a self-limiting condition, currently there is no agent available to
consistently prevent or treat this condition. The goal is to decrease the
severity and duration of mucositis and to provide relief of discomfort, and prevent
or treat infection until recovery.
Things you can do to manage oral problems and bad mouth sores
- 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) if needed.
- Apply lip moisturizer often (i.e. chap stick).Suck on hard candies.
- 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.
- Clean dentures and/or bridge after eating. Leave out dentures if experiencing any
- Floss gently with unwaxed floss (if platelet count adequate).
- May use Water-Pik.
- Mouthwash containing alcohol.
- Lemon glycerin swabs.
- Treat the discomfort/pain.
- Use topical or local agents such as Orajel, or Zilactin-B apply generously.
- Combination mouth wash can be made (ingredients may require prescription).
- Use equal parts: xylocaine viscous solution, Zovirax®
(alcohol-free), and Maalox®, or Mylanta®.
- Take 2 teaspoons every 2-4 hours as needed (swish around mouth and spit out).
- May be advised by healthcare provider to swallow if experiencing discomfort while
- For severe pain: oral or intravenous pain medication*
may be required in addition to topical medication . (* prescribed by healthcare
- Enhance healing:
- Apply Orabase®, Ulcerase®,
etc. to irritated areas in mouth or on lips.
- Apply Vitamin E (puncture cap 400IU and squeeze onto swab. Gently place swab on
- Take an antacid 1/2-1 ounce every 3-4 hours as needed to decrease burning sensation.
- Maintain good nutrition focusing on high protein and high calorie foodswhich
are soft and/or semi liquid (i.e. scrambled eggs, puddings, blenderized or pureed
foods). May use liquid supplements (i.e Carnation Instant Breakfast®,
- Hot, spicy, coarse or rough textured foods.
- Very hot or cold beverages and foods.
- Citric juices or foods containing citric acid (tomatoes, oranges, lemon, etc.).
- Alcoholic beverages or tobacco products.
- Liquid medication containing alcohol (i.e. some cough medicine) if not essential.
Drugs that may be prescribed by your doctor to treat bad mouth sores resulting
from chemotherapy, radiation, or other cancer treatments:
To treat or prevent infection the following may be used:
- Antifungals: Such as nystatin,clotrimizole, fluconozole
- Antibacterials: Mouthwash antiseptic, rinses are the basis
of the oral decontamination regimen.
- Chlorhexidine gluconate (Peridex®, PerioGard®).
- Brush and floss teeth, and completely rinse toothpaste from mouth, before using
- Antivirals: Such as acyclovir (Zovirax®)
or famciclovir (Famvir®)
To protect Gastrointestinal (GI) tract from irritants:
- Gastrointestinal agents: Sucralfate (Carafate®), comes in a liquid suspension form, protects the lining
of the mouth to the stomach from irritants.
- Analgesics for pain control
If you feel your chemo, radiation, or other cancer treatments have resulted
in bad mouth sores or other oral issues, the following guidelines suggest when
to call your doctor or healthcare professional:
- Temperature greater than 100.5 F (38 C).
- Sores or ulcers in mouth or on lips that interfere with eating, drinking or sleeping.
- Pain or any sign of infection ( i.e tongue heavily coated).
- Symptoms increasing in severity despite above recommendations.
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 is meant to be helpful and educational, but is not a substitute
for medical advice.