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Patient Instructions

Radiation therapy or chemotherapy may cause mucositis (tissue swelling) in your mouth. You may have any of these symptoms:

• Mouth pain
• Infection
• Bleeding, if you are getting chemotherapy. Patients getting radiation therapy usually do not have bleeding.
• You may not be able to breathe and eat normally.

In patients getting chemotherapy, mucositis will heal by itself when there is no infection. Healing usually takes 2 to 4 weeks. Mucositis caused by radiation therapy usually lasts 6 to 8 weeks. It will depend on how long you have radiation treatment.

Brush your teeth and gums 2 or 3 times a day for 2 to 3 minutes each time. Use a toothbrush with soft bristles.

• When you brush, rinse your brush in hot water every 30 seconds to keep the bristles soft.
• Let your toothbrush air dry between brushings.
• Choose toothpaste with care.

If toothpaste makes your mouth sore, brush with a solution of 1 teaspoon of salt mixed with 4 cups of water. Pour a small amount into a clean cup to dip your toothbrush into each time you brush. Use a toothpaste with fluoride.

Floss gently 1 time a day. Rinse your mouth 5 or 6 times a day. Use any of these solutions when you rinse:

• 1 teaspoon of salt in 4 cups of water
• 1 teaspoon of baking soda in 1 cup (8 ounces) of water
• ½ teaspoon salt and 2 tablespoons baking soda in 4 cups of water

Avoid rinses that have alcohol in them. You may use an antibacterial rinse 2 to 4 times a day for gum disease. Rinse for 1 to 2 minutes each time.

Do not eat foods or drinks that have a lot of sugar in them. They may cause tooth decay. Use lip care products to keep your lips from drying out and cracking. Sip water to ease mouth dryness.

Ask your doctor about these treatments you can use in your mouth:

• Bland rinses
• Mucosal coating agents
• Water-soluble lubricating agents, including artificial saliva
• Painkillers

Your doctor may also give you pills for pain or drugs to fight infection in your mouth.

Updated by: Andrew Murr, MD, Associate Professor of Clinical Otolaryngology, University of California, San Francisco. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.