Mouth and Throat Changes during and after Chemo

Some types of chemotherapy harm fast-growing cells, such as those that line your mouth, throat, and lips. This can affect your teeth, gums, the lining of your mouth, and the glands that make saliva. Most mouth problems go away a few days after chemotherapy is over.
Mouth and throat problems may include;

• Dry mouth (having little or no saliva)
• Changes in taste and smell (such as when food tastes like metal or chalk, has no taste, or does not taste or smell like it used to)
• Infections of your gums, teeth, or tongue
• Increased sensitivity to hot or cold foods
• Mouth sores
• Trouble eating when your mouth gets very sore

Ways to manage

• Visit a dentist at least 2 weeks before starting chemotherapy. It is important to have your mouth as healthy as possible. This means getting all your dental work done before chemotherapy starts. If you cannot go to the dentist before chemotherapy starts, ask your doctor or nurse when it is safe to go. Be sure to tell your dentist that you have cancer and about your treatment plan.
• Check your mouth and tongue every day. This way, you can see or feel problems (such as mouth sores, white spots, or infections) as soon as they start. Inform your doctor or nurse about these problems right away.
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Keep your mouth moist. You can keep your mouth moist by sipping water throughout the day, sucking on ice chips or sugar-free hard candy, or chewing sugar-free gum. Ask your doctor or nurse about saliva substitutes if your mouth is always dry.

• Brush your teeth, gums, and tongue after each meal and at bedtime.
• Use an extra-soft toothbrush. You can make the bristles even softer by rinsing your toothbrush in hot water before you brush.
• If brushing is painful, try cleaning your teeth with cotton swabs or Toothettes®.
• Use a fluoride toothpaste or special fluoride gel that your dentist prescribes.
• Do not use mouthwash that has alcohol. Instead, rinse your mouth 3 to 4 times a day with a solution of 1/4 teaspoon baking soda and 1/8 teaspoon salt in 1 cup of warm water. Follow this with a plain water rinse.
• Gently floss your teeth every day. If your gums bleed or hurt, avoid those areas but floss your other teeth. Ask your doctor or nurse about flossing if your platelet count is low. 
• If you wear dentures, make sure they fit well and keep them clean. Also, limit the length of time that you wear them.
• Be careful what you eat when your mouth is sore.
• Choose foods that are moist, soft, and easy to chew or swallow. These include cooked cereals, mashed potatoes, and scrambled eggs.
• Use a blender to puree cooked foods so that they are easier to eat. To help avoid infection, be sure to wash all blender parts before and after using them. If possible, it is best to wash them in a dishwasher.
• Take small bites of food, chew slowly, and sip liquids while you eat.
• Soften food with gravy, sauces, broth, yogurt, or other liquids.
• Eat foods that are cool or at room temperature. You may find that warm and hot foods hurt your mouth or throat.
• Suck on ice chips or popsicles. These can relieve mouth pain.
• Ask your dietitian for ideas of foods that are easy to eat. For ideas of soft foods that are easy on a sore mouth
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