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Mouth Sores (mucositis) are a common side effect of radiation and chemotherapy. Mouth sores may range from mild to severe and may cause discomfort. Medication can be prescribed to alleviate any pain related to mouth sores. A mouth care regimen is important.
A burning sensation inside the mouth three to 10 days after chemo begins may
signal the beginning of mouth sores. There's no cure but you can take steps to lessen the discomfort while the the sores run their course. It usually takes the cells inside the mouth 7 to 14 days to
regenerate and heal the sores.
Prevention
A regimen of mouth hygiene should start before the chemo. Brush your teeth 3 to 4 times a day with a soft bristle toothbrush or sponge. Use floss.
Patients receiving 5-FU or methotrexate are at particularly high risk of developing mouth sores. Frequent rinsing with salt water, baking soda, or chlorhexidine following the start of chemotherapy is
often recommended.
Helpful Hints for managing mouth ulcers -
You may want to talk
to your doctor about the products mentioned below.
Once sores have developed,
topical analgesics can be prescribed and you can take steps to lessen your discomfort. A topical painkiller like
Xylocaine (gel or spray) can provide temporary relief. Protective agents such as kaopectate and sucralfate can be used to cover the sores and provide some relief.
Don't eat spicy, hot, acidic or coarse foods. Stick with soft, moist foods for the time being.
Stay away from topical steroid, which can increase your risk of infections.
| Drug
name |
Usual
dose |
Side
Effects |
| Saline
mouthwash |
swish
and swallow every 2 to 6 hours |
None |
| Baking
soda mouthwash |
1/2
tsp. salt plus 1/2 tsp. baking soda in a cup of warm water,
rinse every 3 or 4 hours |
None |
| Chlorhexidine
(Peridex) |
Rinse
every 4 hours |
Taste,
color, teeth staining |
| Betadine
mouthwash |
Diluted
with water 50-50 10 cc 3 times a day and as needed applied
locally or swish |
Iodine
allergy, color, teeth staining |
| Xylocaine (Lidocaine) |
GEL:
5 to 15 mL every 4 hours SPRAY: 1 spray every 4 hours |
Possible systemic effect |
| Sucralfate
or kaopectate |
10
to 30 mL every 2 to 6 hours, swish and spit |
Taste |
Dealing with
Infections
Damage to the mucous membrane can lead to
opportunistic infections in the mouth such as candida and herpes simplex
virus infections. Thursh is a fungal infection that is treatable with anti-fungal
agents such as clotrimazole or nystatin.
When infection is more severe, oral ketoconazole, fluconazole, or
intravenous amphotericin may be used.
|
Drug Name |
Usual dose |
Side effects |
| Clotrimazole troches (Mycelex) |
Place troche in mouth
4 to 5 times a day, for 7 to 14 days |
Well tolerated, taste |
| Nystatin suspension |
1 teaspoonful every 4
to 6 hours, swish and swallow |
Well tolerated,
irritation |
| Fluconazole (Diflucan) |
100mg every day |
Nausea, vomiting,
itching |
| Amphotericin B |
Intravenous dose
varies |
Headache, fever,
chills. |
| Amphotericin B
mouthwash |
10mg swish and swallow
every day |
Taste |
SOURCE:
From Supportive
Cancer Care by Ernest H. Rosenbaum, MD & Isadora R.
Rosenbaum, MA
This page was last edited on 7/23/2008
Written by: Rachael Myers
Lowe, cancerpage.com
Clinical review by: Jan Smith, RN, OCN
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