Sore mouth or gut (mucositis)

Taking care of your mouth, teeth and gums can reduce pain, bleeding, infection and dental problems caused by oral mucositis. Here are some simple things you can do:

• Make sure you see your dentist before you start treatment.
• Brush your teeth and gums at least twice a day using a very soft child’s toothbrush and a mild fluoride toothpaste.
• Ideally brush after every meal and before bed.
• Rinse your brush and store it in a cup with the head facing up.
• Change your toothbrush every month.
• If you’re used to cleaning between your teeth, carry on using floss or interdental brushes. Don’t start flossing during treatment if you haven’t been doing it before as you risk making your gums bleed.
• Rinse your mouth with a mild alcohol-free mouthwash, plain water or saltwater throughout the day. For a saltwater rinse, add a teaspoon of table salt to 900ml of cold or warm water that’s previously been boiled, and use within 24 hours.
• You might find it soothing to suck on ice cubes or crushed ice, especially if you have a dry mouth. Ice creams or ice lollies may also help.

It may also be helpful to avoid things which can irritate or damage the inside of your mouth, such as:

• smoking
• alcohol, including alcohol-based mouthwashes
• rough or hard foods such crusty bread or crisps
• hot drinks
• spicy foods
• acidic foods like tomatoes, oranges and lemons.

The NHS has advice and a list of services if you need support to stop smoking or cut down on alcohol.

Try not to wear your dentures if your mouth is sore. Brush them at least twice a day with toothpaste and rinse with water. Make sure you also brush your gums with a soft toothbrush.

If you have an oral infection such as thrush, soak your dentures in a suitable disinfectant (chlorhexidine or sodium hypochlorite) for 15 minutes twice a day

If you have diarrhoea, it’s important to avoid dehydration. Try to drink at least two litres of water a day. You can mix in cordial or squash if you like.

Things to avoid include spicy foods and acidic foods, such as tomatoes, oranges and lemons.

If you have oral mucositis with mild symptoms, it usually takes three to four weeks to get better after you’ve finished chemotherapy. More severe symptoms may take longer, and you may need to stay in hospital to be treated and monitored.

If you have GI mucositis, most of the symptoms should stop a few weeks after your treatment has finished, although occasionally diarrhoea can continue for some months after radiotherapy.