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Dry mouth during cancer treatment

Chemotherapy - dry mouth; Radiation therapy - dry mouth; Transplant - dry mouth; Transplantation - dry mouth

Some cancer treatments and medicines can cause dry mouth. Take good care of your mouth during your cancer treatment. Follow the measures outlined below.

What to Expect

Symptoms of dry mouth include:

  • Mouth sores
  • Thick and stringy saliva
  • Cuts or cracks in your lips, or at the corners of your mouth
  • Your dentures may no longer fit well, causing sores on the gums
  • Thirstiness
  • Difficulty swallowing or talking
  • Loss of your sense of taste
  • Soreness or pain in the tongue and mouth
  • Cavities (dental caries)
  • Gum disease

Take Care of Your Mouth

Not caring for your mouth during cancer treatment can lead to an increase in bacteria in your mouth. The bacteria can cause infection in your mouth, which can spread to other parts of your body.

  • Brush your teeth and gums 2 to 3 times a day for 2 to 3 minutes each time.
  • Use a toothbrush with soft bristles.
  • Use toothpaste with fluoride.
  • Let your toothbrush air dry between brushings.
  • If toothpaste makes your mouth sore, brush with a solution of 1 teaspoon (tsp) or 5 grams (g) of salt mixed with 4 cups (c) or 1 liter (L) of water. Pour a small amount into a clean cup to dip your toothbrush into each time you brush.
  • Floss gently once a day.

Rinse your mouth 5 or 6 times a day for 1 to 2 minutes each time. Use the following solution when you rinse:

  • 1 tsp (5 g) salt and 1 tsp (5 g) baking soda in 4 c (1 L) water

Do not use mouth rinses that have alcohol in them. You may use an antibacterial rinse 2 to 4 times a day for gum disease.

Other tips for taking care of your mouth include:

  • Avoiding foods or drinks that have a lot of sugar in them that may cause tooth decay
  • Using lip care products to keep your lips from getting dry and cracking
  • Sipping water to ease mouth dryness
  • Eating sugar-free candy or chewing sugar-free gum

Talk with your dentist about:

  • Solutions to replace minerals in your teeth
  • Saliva substitutes
  • Medicines that help your salivary glands make more saliva

Diet

You need to eat enough protein and calories to keep your weight up. Ask your health care provider about liquid food supplements that can help you meet your caloric needs and keep up your strength.

To make eating easier:

  • Choose foods that you like.
  • Eat foods with gravy, broth, or sauce to make them easier to chew and swallow.
  • Eat small meals and eat more often.
  • Cut your food into small pieces to make it easier to chew.
  • Ask your provider or dentist if artificial saliva might help you.

Drink 8 to 12 c (2 to 3 L) of liquid each day (not including coffee, tea, or other drinks that have caffeine).

  • Drink liquids with your meals.
  • Sip cool drinks during the day.
  • Keep a glass of water next to your bed at night. Drink when you get up to use the bathroom or other times you wake up.

Do not drink alcohol or beverages that contain alcohol. They will bother your throat.

Avoid foods that are very spicy, that contain a lot of acid, or that are very hot or very cold.

If pills are hard to swallow, ask your provider if it is OK to crush your pills. (Some pills do not work if they are crushed.) If it is OK, crush them up and add them to some ice cream or another soft food.

References

Majithia N, Hallemeier CL, Loprinzi CL. Oral complications. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 40.

National Cancer Institute website. Chemotherapy and you: support for people with cancer. www.cancer.gov/publications/patient-education/chemotherapy-and-you.pdf. Updated January 2024. Accessed May 29, 2024.

National Cancer Institute website. Mouth and throat problems: cancer treatment side effects. www.cancer.gov/about-cancer/treatment/side-effects/mouth-throat. Updated September 24, 2021. Accessed May 29, 2024.

National Cancer Institute website. Oral complications of cancer therapies (PDQ)–health professional version. www.cancer.gov/about-cancer/treatment/side-effects/mouth-throat/oral-complications-hp-pdq. Updated February 16, 2024. Accessed May 29, 2024.

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Review Date: 3/31/2024

Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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