Dry mouth

Treatments that help your body fight cancer may elicit a number of side effects. If you’re receiving chemotherapy or radiation therapy for cancer, you may notice symptoms of dry mouth.

Oral side effects such as dry mouth are common, and oral complications may be especially common if you’re undergoing treatment for head or neck cancer.

Dry mouth manifests in a variety of ways, including:

• Feeling thirsty
• Having mouth sores
• Losing the ability to taste
• Having stringy or thick saliva
• Having cracks or cuts in the corners of your mouth or in your lips
• Having dentures that no longer fit correctly, which leads to gum sores
• Having trouble swallowing or speaking
• Feeling tongue or mouth pain or soreness
• Developing dental cavities

How cancer treatment may cause dry mouth

Receiving treatment for cancer may make you more prone to oral side effects and complications for several reasons. One reason is that chemotherapy and radiation therapy impede the growth of new cells or cells that grow quickly. Both cancer cells and normal cells in the lining of your mouth are fast-growing, and treatment may slow them down.

In addition, chemotherapy and radiation therapy may alter the balance of normal, healthy bacteria present in your mouth. Radiation therapy may also damage the salivary glands, which produce saliva.

The cell structure and saliva in your mouth typically bounce back after treatment ends.

Why it’s important to speak with your care team if you have dry mouth

As you undergo treatment for cancer, it’s important to address any symptoms of dry mouth you may be experiencing, especially if you’re having trouble eating, drinking, swallowing, sleeping or otherwise feeling discomfort. Symptoms of dry mouth that impede your ability to eat or drink may result in malnutrition or dehydration.

Because cancer treatment may alter the balance of bacteria in your mouth, you may be more prone to cavities and dental decay. Speaking with your dentist or doctor may help you decide on a plan to care for your teeth and mouth during this time.

How to manage dry mouth caused by cancer treatment

If you’re experiencing dry mouth while receiving cancer treatment, there are steps that may help alleviate this side effect. If dry mouth is affecting your ability to eat and swallow, be sure to:

• Eat foods that are wet, soft and easily swallowed if your mouth or throat is sore
• Steer clear of foods that are acidic, hot or spicy
• Try marinating or seasoning foods if you’ve lost your sense of taste or if you find that foods taste bland (as long as you avoid hot or spicy seasonings)
• Chew your food well if you’re having trouble swallowing foods, and only take small bites
• Combine solid foods with liquid foods such as yogurt, gravy, sauces or milk.
• Cut down on sugar-containing foods to help avoid tooth decay
• Try sugar-free hard candies or gum (especially mint, citrus or cinnamon-flavored ones) to help jumpstart saliva production in your mouth

Staying hydrated is especially important when it comes to relieving dry mouth. Make sure you:

• Drink plenty of fluids (2-3 quarts each day), especially if your mouth feels dry
• Stay away from alcohol and tobacco
• Take sips of fluids while eating to add moisture to your food and help you swallow
• Sip cold water between meals
• Try sucking on ice chips

Good oral care also plays a key role in alleviating dry mouth and preventing oral complications. In addition to seeing your dentist as needed, take these steps:

• Use a soft-bristle toothbrush and brush your teeth and gums two to three times a day for two to three minutes each time.
• If your toothbrush isn’t soft enough, try rinsing it under hot water every 15 to 30 seconds. This helps make the bristles feel softer.
• Use toothpaste containing fluoride. (If using toothpaste is painful for you, try mixing a solution containing 1 teaspoon of salt and 4 cups of water. Use a clean cup containing a small amount of this solution and dip your toothbrush into the solution when you brush your teeth).
• Allow your toothbrush to air-dry between uses.
• Avoid over-the-counter mouthwashes that contain alcohol.
• Gently floss your teeth once a day.
• Every two hours, rinse your mouth to alleviate soreness. Use a mixture of 1/4 teaspoon of salt, 1/4 teaspoon of baking soda and 1 quart of water; or try a solution recommended by your cancer care team.
• If you have gum disease, you may use an antibacterial mouth rinse two to four times a day, for one to two minutes each time. Ask your care team which one you should use.

Other options that may alleviate symptoms of dry mouth include:

• Over-the-counter artificial saliva rinses or sprays
• Mild lip balm, cocoa butter or petroleum jelly to moisturize your lips
• Acupuncture