What is an Oral Mucositis

Oral mucositis is a mouth condition that may develop as a result of treatments for cancer. Sores may appear on your lips, gums, tongue, throat, and the top (roof) or bottom (floor) of your mouth.

What are the causes?

This condition can happen to anyone who is being treated with cancer therapies, including:

• Cancer medicines (chemotherapy).
• Radiation therapy.
• Bone marrow transplants and stem cell transplants.

Cancer treatments can damage the lining of the mouth, which causes this condition. Oral mucositis is not caused by infection. However, the sores can become infected after they form. Infection can make oral mucositis worse.

What increases the risk?

The following factors may make you more likely to develop this condition:

• Having poor oral hygiene.
• Having dental problems or oral diseases.
• Using products that contain nicotine or tobacco, such as cigarettes, chewing tobacco, and e-cigarettes.
• Drinking alcohol.
• Having other medical conditions, such as diabetes, HIV, AIDS, or kidney disease.
• Not drinking enough clear fluids.
• Wearing dentures that do not fit correctly.
• Having cancers that primarily affect the blood.
• Having cancers of the head and neck.
• Receiving radiation therapy to the head and neck region.

What are the signs or symptoms?

Symptoms of this condition can vary from mild to severe. Symptoms are usually seen 7–10 days after cancer treatment has started. They include:

• Mouth sores. These sores may bleed.
• Color changes inside the mouth. Red, shiny areas may appear.
• White patches or pus in the mouth.
• Pain in the mouth and throat. This can make it painful to speak and swallow.
• Dryness and a burning feeling in the mouth.
• Saliva that is dry and thick.
• Trouble eating, drinking, and swallowing. This can lead to weight loss.

How is this diagnosed?

This condition can be diagnosed with a physical exam.

In some cases, lab tests or cultures may be done to check for an associated infection.

How is this treated?

Treatment depends on the severity of the condition. Oral mucositis often heals on its own. Sometimes, changes in the cancer treatment can help. Treatment may include medicines, such as:

• An antibiotic medicine to fight infection, if present.
• Medicine to help the cells in your mouth heal more quickly.

Medicine may also be given to help control pain. This may include:

• Pain relievers that are swished around in the mouth. These make the mouth numb to ease the pain (topical anesthetics).
• Mouth rinses.
• Prescribed, medicated gels. The gel coats the mouth. This protects nerve endings and lessens the pain.
• Pain medicines.

Follow these instructions at home:

Medicines

• Take or apply over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take or apply it as told by your health care provider. Do not stop using the antibiotic even if you start to feel better.
• Do not use products that contain benzocaine (including numbing gels) to treat mouth pain in children who are younger than 2 years. These products may cause a rare but serious blood condition.

Eating and drinking

• Talk to a diet and nutrition specialist (dietitian) about what you should eat and drink if you have mucositis.
• Drink high-nutrition and high-calorie shakes or supplements.
• Eat bland and soft foods that are easy to eat.
• Drink enough fluid to keep your urine pale yellow.
• Do not eat foods that are hot, spicy, citrus, or hard to swallow.
• Do not drink alcohol.

Lifestyle

• Keep your mouth clean and germ-free. To maintain good oral hygiene:
  • Brush your teeth carefully with a soft toothbrush at least two times each day. Use a gentle toothpaste. Ask your health care provider to recommend the right toothpaste for you.
  • Use a soft sponge (oral swab) to clean your mouth and teeth instead of a toothbrush if mouth sores are severe.
  • Floss your teeth every day.
  • Have your teeth cleaned regularly as recommended by your dentist.
  • Rinse your mouth after every meal or as directed by your health care provider. Do not use mouthwash that contains alcohol. Ask your health care provider for a mouthwash or mouth rinse recommendation.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.

General instructions

• Follow instructions from your health care provider about:
  • Cleaning mouth sores.
  • Taking out your dentures.
  • Changing your diet or finding other ways to get nutrients. This is important if you are losing weight.
• If your lips are dry or cracked, apply a water-based moisturizer to your lips as needed.
• Try sucking on ice chips or sugar-free frozen pops. This may help with pain. This also keeps your mouth moist.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have mouth pain or throat pain.
• You are having more trouble swallowing.
• Your symptoms get worse.
• You have new symptoms.
• Your pain is not controlled with medicine.
• You have trouble speaking.

Get help right away if you:

• Have a fever.
• Cannot swallow solid food or liquids.
• Have a lot of bleeding in your mouth.
• Develop new, open, or draining sores in your mouth.

Summary

• Oral mucositis is a mouth condition that may develop as a result of treatments for cancer. Sores may appear on your lips, gums, tongue, throat, and the top (roof) or bottom (floor) of your mouth.
• Cancer treatments can damage the lining of the mouth, which causes this condition.
• Treatment depends on how severe the condition is. It may include medicine to fight infection, medicine to ease pain, or medicine to help the cells in your mouth heal more quickly.