Symptom Specific Services

Dry Mouth
• What mouth problems can occur and what are the symptoms?
• How does chemotherapy treatment influence dry mouth?
• How does radiation oncology influence dry mouth?
• What can I do to manage a dry mouth before beginning cancer treatment?
• What can I do to manage dry mouth after cancer treatment?
• What services are available to help manage symptoms of dry mouth?

What mouth problems can occur and what are the symptoms?
Mouth problems can significantly reduce your quality of life and may make it difficult for you to receive cancer treatment. Sometimes treatment must be stopped completely. The most common oral symptoms from chemotherapy and radiation oncology are dryness, infection, inability to taste normally, and pain.

Dry mouth can occur when the salivary glands produce too little saliva and can lead to the development of cavities and gum diseases. Other effects include dehydration and malnutrition. Symptoms of dry mouth include:

• Dryness

• Soreness or a burning feeling, especially on the tongue

• Cracked lips

• Cuts or cracks at the corners of the mouth

• Changes in the surface of the tongue

• Difficulty wearing dentures

• Difficulty drinking fluids

Dry mouth causes the following changes in the mouth:

• Saliva does not moisten and becomes thick and stringy

• Acid in the mouth cannot be neutralized, and minerals are lost from the teeth

• Bacteria in the mouth are more likely to cause diseases

• Plaque becomes heavy and thick, and particles stay in the mouth and between teeth

• Acid that is produced after eating or drinking sugary foods causes more mineral loss from the teeth, which leads to dental decay

Sores in the mouth and throat can be caused by some anti-cancer drugs, a condition called stomatitis or mucositis. Anti-cancer drugs can also make mouth tissue dry and irritated or cause the mouth to bleed. Patients who have not been eating well since beginning chemotherapy are more likely to get mouth sores. In addition to being painful, mouth sores can become infected by the many germs that live in the mouth. Every step should be taken to prevent infections, because they can be hard to fight during chemotherapy and can lead to serious problems.

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How does chemotherapy treatment influence dry mouth?
Chemotherapy causes acute dry mouth complications that usually heal after treatment ends. Complications can be acute (occurring only during therapy) or chronic (occurring for months to years after therapy).

Open sores in the mouth occur in many patients receiving chemotherapy. Half of the patients develop severe lesions that require medical treatment, including changes in cancer medication. Lesions usually begin to appear about two weeks after therapy begins and remain until blood counts return to normal.

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How does radiation oncology influence dry mouth?
Radiation can cause acute dry mouth complications, but it can also be responsible for permanent tissue damage, which results in chronic problems. Radiation to the head and neck can cause the same oral problems as chemotherapy. The damage experienced depends on the amount and kind of radiation used, the total dose used, and the size of the area treated.

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What can I do to manage a dry mouth before beginning cancer treatment?
Oral complications in patients with head and neck cancer can be minimized when aggressive prevention measures are taken before treatments begins. Primary preventive measures include:

• A well-balanced diet

• Good oral cleaning

• Early identification of oral problems

A dentist or dental hygienist who understands the oral complications of cancer treatment should examine you before you begin chemotherapy or radiation oncology to the head and neck. This examination should occur at least one month before treatment, to allow any necessary dental work to heal. The dentist or hygienist should teach you how to care for your teeth.

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What can I do to manage dry mouth after cancer treatment?
Good dental hygiene is an effective way to help minimize the oral effects of cancer treatment, such as cavities. If you experience dry mouth, you should consider the following strategies to minimize the risk of oral lesions:

• Perform oral hygiene at least four times per day.

• Use toothpaste with fluoride when brushing. Some over-the-counter mouthwashes and toothpastes contain fluoride (such as Biotene), and may help.

• Apply fluoride gel daily at bedtime.

• Rinse with a solution of salt and baking soda four to six times per day.

• Avoid foods and liquids with a high sugar content.

• Sip water to alleviate mouth dryness. Try flavoring water with a few drops of lemon, mint or other flavor. Consider adding a few drops of glycerine, available without a prescription as “glycerine USP.” This will help the water stick to the inside of the mouth, extending relief.

• Spray your mouth often. Buy an inexpensive spray bottle you can carry with you.

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What services are available to help manage symptoms of dry mouth?
At Continuum Cancer Centers of New York, we provide education, supportive care, and treatment of symptoms. You will be closely monitored for pain, ability to cope and your response to treatment. There may also be research protocols available for specific patients who suffer from dry mouth caused by radiation treatments.

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