What should I do about mouth sores?

ACS Answer

Mouth sores are like little cuts or ulcers in the mouth. The sores may be very red, or may have small white patches in the middle. They may bleed. They can appear 1-2 weeks after chemotherapy. They can also be caused by radiation therapy, infection, dehydration, poor mouth care, oxygen therapy, alcohol, tobacco, or lack of protein. Healing takes 2-4 weeks.

What to look for

• Inside of mouth and gums look red, shiny, or swollen
• Blood in mouth
• Small ulcers or sores in mouth, on gums, or on tongue
• A white or yellow film in the mouth
• Pain in mouth
• Feeling of dryness, mild burning, or increased sensitivity to hot and cold foods
• Soft whitish patches or pus in the mouth
• Increased mucus in the mouth

What to do

• Check your mouth twice a day using a small flashlight and a padded tongue blade. If you wear dentures, remove them before inspecting your mouth. Report any changes in appearance, taste, or feeling to your doctor or nurse.
• Follow this plan for mouth care 30 minutes after eating and every 4 hours while awake:
  • Brush your teeth using a soft nylon bristle toothbrush. To increase the softness of the bristles, soak the brush in hot water before brushing, and rinse the brush with hot water during brushing. If the toothbrush hurts, use a Popsicle stick with gauze wrapped around it or a cotton swab instead.
  • Rinse toothbrush well after use and store in a cool, dry place.
  • Use a nonabrasive toothpaste or a baking soda solution.
  • Remove and clean dentures between meals.
  • Gently rinse mouth before and after meals and at bedtime with either:
    • 1 teaspoon of baking soda dissolved in 2 cups of water, or ½ teaspoon of salt dissolved in 1 quart of water.
    • Mix right before use and hold in mouth for 1½minutes.
• Keep lips moist with petroleum jelly or lip balm.
• Drink at least 2-3 quarts of fluids daily, with approval from your doctor.
• If mouth pain is severe or interferes with eating, ask your doctor to recommend a medicine that can be swished 15-20 minutes before meals or painted on the sore with a Q-tip before meals. Hold the solution in your mouth for several minutes before swallowing or spitting it out.
• To promote healing, ask your doctor about using Maalox or Milk of Magnesia. (Allow this to settle and separate, pour the liquid off the top of the solution, and swab the pasty part onto the sore area with a Q-tip. Rinse with water after 15-20 minutes.)
• Sip warm tea slowly.
• Rinse mouth with 1 teaspoon of Kaopectate, then spit it out.
• Eat chilled foods and fluids (e.g., popsicles, ice cubes, frozen yogurt, sherbet, ice cream).
• Eat small, frequent meals of bland, non-spicy foods.
• Establish a pleasant mealtime atmosphere.

Do not

• Use a hard, coarse toothbrush
• Use commercial mouthwash preparations
• Use dental floss
• Use lemon or glycerine swabs
• Use tobacco or alcohol
• Wear loose dentures, which can cause irritation; if mouth sores are severe, do not use dentures at all
• Eat citrus fruits, such as oranges, lemons, limes, and tomatoes, or drink the juices of these fruits; instead, drink less acidic juices like apricot, pear, or peach juice
• Drink carbonated beverages
• Eat hard or coarse foods, such as hard breads, crackers, raw vegetables, potato chips, or pretzels
• Eat hot, spicy foods, such as pepper, curry powder, or horseradish

Call the doctor about any of the following symptoms

• Redness or shininess in the mouth that lasts for more than 48 hours
• Bleeding gums
• Any type of cut or sore in the mouth
• A temperature of 100.5°F or higher
• White patches on your tongue or on the inside of your mouth

Related Resources

Find books that cover this and other cancer topics at the American Cancer Society bookstore.

Recommended Consultation

You should consider discussing this question with your doctor or health care team.

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