Chemotherapy

and Your Mouth

Chemotherapy

and Your Mouth

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

National Institutes of Health

National Institute of Dental and Craniofacial Research
Oral Health, Cancer Care, and You is 

an awareness campaign sponsored 

by the National Institute of Dental 

and Craniofacial Research (NIDCR) 

through its National Oral Health 

Information Clearinghouse (NOHIC).

This campaign is being conducted in 

partnership with the National Cancer 

Institute, the National Institute of 

Nursing Research, the Centers for 

Disease Control and Prevention, and 

the Friends of the NIDCR. For more 

information about the campaign, 

please contact NOHIC. Campaign 

publications are also available online 

at www.nidcr.nih.gov.

National Oral Health

Information Clearinghouse

1 NOHIC Way

Bethesda, MD 20892–3500

Phone: 301–402–7364

Fax: 301–480–4098
1

Are You Being Treated 

With Chemotherapy 

for Cancer?

If so, this booklet can help you. While 

chemotherapy helps treat cancer, it can 

also cause other things to happen in your 

body called side effects. Some of these 

problems affect the mouth and could 

cause you to delay or stop treatment. 

This booklet will tell you ways to help 

prevent mouth problems so you’ll get 

the most from your cancer treatment.

To help prevent serious problems, see 

a dentist at least 2 weeks before starting chemotherapy.

A dentist can help prevent mouth 

problems.
2

How Does 

Chemotherapy Affect 

the Mouth?

Chemotherapy is the use of drugs to 

treat cancer. These drugs kill cancer 

cells, but they may also harm normal 

cells, including cells in the mouth. Side 

effects include problems with your 

teeth and gums; the soft, moist lining of 

your mouth; and the glands that make 

saliva (spit).

It’s important to know that side 

effects in the mouth can be serious.

• The side effects can hurt and make 

it hard to eat, talk, and swallow. 

• You are more likely to get an infection, which can be dangerous when 

you are receiving cancer treatment.

• If the side effects are bad, you may 

not be able to keep up with your 

cancer treatment. Your doctor may 

need to cut back on your cancer 

treatment or may even stop it.
3

You can see or feel most of these 

problems. Check your mouth every day.

What Mouth 

Problems Does 

Chemotherapy Cause?

You may have certain side effects in 

your mouth from chemotherapy. Another person may have different problems. The problems depend on the 

chemotherapy drugs and how your 

body reacts to them. You may have 

these problems only during treatment 

or for a short time after treatment ends. 

• Painful mouth and gums.

• Dry mouth.

• Burning, peeling, or swelling 

tongue.

• Infection.

• Change in taste. 
4

Why Should I See 

a Dentist?

You may be surprised that your dentist 

is important in your cancer treatment.

If you go to the dentist before chemotherapy begins, you can help prevent 

serious mouth problems. Side effects 

often happen because a person’s 

mouth is not healthy before chemotherapy starts. Not all mouth problems 

can be avoided but the fewer side 

effects you have, the more likely you 

will stay on your cancer treatment 

schedule.

It’s important for your dentist and 

cancer doctor to talk to each other 

about your cancer treatment. Be sure 

to give your dentist your cancer 

doctor’s phone number.

When Should I See a Dentist?

You need to see the dentist at least 2 

weeks before chemotherapy begins.

If you have already started chemotherapy and didn’t go to a dentist, see one 

as soon as possible.
5

The dentist will do a complete exam.

What Will the Dentist 

and Dental Hygienist Do?

• Check your teeth.

• Take x-rays.

• Take care of mouth problems.

• Show you how to take care of your 

mouth to prevent side effects.
6

What Can I Do To Keep 

My Mouth Healthy?

You can do a lot to keep your mouth 

healthy during chemotherapy. The first 

step is to see a dentist before you 

start cancer treatment. Once your 

treatment starts, it’s important to look

in your mouth every day for sores or 

other changes. These tips can help 

prevent and treat a sore mouth:

Keep your mouth moist.

• Drink a lot of water.

• Suck ice chips.

• Use sugarless gum 

or sugar-free hard 

candy.

• Use a saliva 

substitute to help 

moisten your 

mouth.
7

Clean your mouth, tongue, and gums.

• Brush your teeth, gums, and tongue 

with an extra-soft toothbrush after 

every meal and at bedtime. If 

brushing hurts, soften the bristles 

in warm water.

• Use a fluoride toothpaste.

• Don’t use mouthwashes with alcohol 

in them.

• Floss your teeth 

gently every 

day. If your 

gums bleed 

and hurt, 

avoid the areas that are bleeding or 

sore, but keep flossing your other 

teeth.

• Rinse your mouth several times a 

day with a solution of 1/4 teaspoon 

baking soda and 1/8 teaspoon salt 

in one cup of warm water. Follow 

with a plain water rinse.

• Dentures that don’t fit well can 

cause problems. Talk to your cancer doctor or dentist about your 

dentures.
8

If Your Mouth Is Sore, Watch What 

You Eat and Drink.

• Choose foods that are good for you 

and easy to chew and swallow. 

• Take small bites of food, chew 

slowly, and sip liquids with your 

meals.

• Eat soft, moist foods such as cooked 

cereals, mashed potatoes, and 

scrambled eggs.

• If you have trouble swallowing, 

soften your food with gravy, sauces, 

broth, yogurt, or other liquids.

Sipping liquids with your meals will 

make eating easier.
9

Call Your Doctor or Nurse When Your 

Mouth Hurts.

• Work with them to find medicines 

to help control the pain.

• If the pain continues, talk to your 

cancer doctor about stronger 

medicines.

Remember To Stay Away From

• Sharp, crunchy foods, like 

taco chips, that could 

scrape or cut your 

mouth.

• Foods that are hot, 

spicy, or high in 

acid, like citrus 

fruits and juices, 

which can irritate 

your mouth.

• Sugary foods, 

like candy or 

soda, that could cause cavities.

• Toothpicks, because they can cut 

your mouth.

• All tobacco products.

• Alcoholic drinks.
10

Your child has special dental needs.

Do Children Get 

Mouth Problems Too?

Chemotherapy causes other side effects 

in children, depending on the child’s age. 

Problems with teeth are the most common. Permanent teeth may be slow to 

come in and may look different from 

normal teeth. Teeth may fall out. The 

dentist will check your child’s jaws for 

any growth problems. 

Before chemotherapy begins, take your

child to a dentist. The dentist will check

your child’s mouth carefully and pull 

loose teeth or those that may become 

loose during treatment. Ask the dentist 

or hygienist what you can do to help 

your child with mouth care.
11

Remember:

• Visit your dentist before your 

cancer treatment starts.

• Take good care of your mouth 

during treatment.

• Talk regularly with your cancer 

doctor and dentist about any

mouth problems you have. 

Call your cancer doctor or dentist if 

you have any mouth problems.
Acknowledgments

The individuals listed here provided assistance in developing, 

reviewing, and field testing all of the campaign publications. 

The campaign sponsors would like to thank them for their 

contributions.

Scientific Committee

Gerry Barker, R.D.H., M.A.

University of Missouri-Kansas City

Kansas City, MO 

Susan L. Beck, R.N., Ph.D., A.O.C.N.

University of Utah 

Salt Lake City, UT

Marylin Dodd, R.N., Ph.D.

University of California, San Francisco

San Francisco, CA

Joel Epstein, D.M.D., M.S.D., F.R.C.D.

University of Washington

Seattle, WA

Philip Fox, D.D.S.

Bethesda, MD

Deborah McGuire, R.N., Ph.D.

University of Pennsylvania

Philadelphia, PA

Douglas Peterson, D.M.D., Ph.D.

University of Connecticut

Farmington, CT 

Mark M. Schubert, D.D.S., M.S.D.

University of Washington

Seattle, WA

John Wingard, M.D.

University of Florida 

Gainesville, FL

Field Testers

Olubunmi Abayomi, M.D.

Howard University Hospital

Washington, DC

Alice Bass, B.S.N., O.C.N.

Greater Southeast Community Hospital

Washington, DC

Betsy Bischoff, R.N., M.S.

Georgetown University Medical Center 

Washington, DC

Andrea Bonnick, D.D.S.

Howard University 

Washington, DC

Dorothy Chesley, R.N., Ph.D.

Texas Nursing Foundation

Austin, TX

Nancy E. Leupold, M.S.

Support for People with Oral and 

Head and Neck Cancer (SPOHNC)

Locust Valley, NY

Alice Mahan, B.S., R.T.T.

Howard University Hospital 

Washington, DC

MiKaela Olsen, R.N., M.S., O.C.N.

UCSF Stanford Health Care

Stanford, CA

Peter Passero, D.D.S.

Prizm Dental Partners and Management Group

McLean, VA

K. Vendrell Rankin, D.D.S.

Baylor College of Dentistry

Dallas, TX
C
National Institute of Dental

and Craniofacial Research

National Oral Health 

Information Clearinghouse

1 NOHIC Way

Bethesda, MD 20892–3500

301–402–7364

www.nidcr.nih.gov

This publication is not 

copyrighted. Make as many 

photocopies as you need.

U.S. Department of Health 

and Human Services

National Institutes of Health

NIH Publication No. 05–4361

Reprinted September 2005