Oral hygiene advice for patients at risk of oral mucositis while receiving cancer therapy

Symptoms of mucositis can include:

• Pain or discomfort in the mouth
• Higher risk of infection
• Changes in appetite and taste
• Reduced food intake and weight loss
• Emotional distress

If you need more information about oral mucositis, please speak with your healthcare team or call the Acute Haematology and Oncology Unit (AHOU) to be assessed. It is important to keep your mouth clean during cancer treatment and to report any changes in your mouth early to help prevent problems related to oral mucositis.

Tips to maintain oral hygiene

Before Cancer Treatment

• Visit your dentist for a check-up and cleaning to ensure your mouth is in good health.

During Cancer Treatment

• Use a low-abrasive fluoride toothpaste (1000-1500 ppm). You may be advised to use a higher fluoride toothpaste if you have a greater risk of dental decay.
• Brush your teeth, gums, and tongue two to four times a day with a soft toothbrush, after meals and before bed. Use circular motions and spit out excess toothpaste.
• Clean your toothbrush with water after use, store it upright, and replace it every month.
• If you usually floss or use interdental cleaners, continue to do so with care. If you have a low platelet count or are getting head and neck cancer treatment, ask your team for advice before using these products. You may be prescribed different products, such as Caphosol or GelX.
• If you wear dentures, make sure they fit well. Clean them after meals and soak them in water overnight in a closed container.
• Use a bland mouthwash (no alcohol) four times a day, at a different time than when you brush your teeth. This helps reduce harmful bacteria in your mouth. You can make a simple mouthwash by mixing one teaspoon of salt with 200ml of water.

After cancer treatment

Your mouth may be tender for some time after treatment. Continue with the good oral hygiene practices until any symptoms are gone. If they continue, contact your healthcare team.

Other tips

• Limit your alcohol and tobacco use to protect your mouth lining.
• Drink plenty of water to keep your mouth moist. If your mouth is dry, ask your healthcare team about products that can help.
• Stay hydrated by drinking liquids often and eating moist foods with extra sauces or gravy.
• If your mouth becomes sore, avoid hot, spicy, salty, and acidic foods.
• Regular paracetamol can help but remember it can hide a fever. If you feel unwell, contact the acute haematology and oncology unit (AHOU) for assessment.

Preventing other oral infections

Oral thrush is a common infection that appears as painful white patches in the mouth. Good oral hygiene can help prevent this. If you think you have an oral infection, contact your healthcare team for treatment.