The mouth itself can become infected, and the loss of skin in the mouth can allow disease-causing organisms to get into the bloodstream. Once the mouth is affected, even normal good bacteria can cause infections, as well as disease-causing organisms picked up from the hospital or other sources. As the white blood cell count gets lower, the frequency and seriousness of infection increases. Patients who have low white blood cell counts for a long time are more at risk of developing serious infections. Antibiotics used over a long period of time change the number of normal organisms in the mouth and allow an excessive growth of fungi.
Steroids given at the same time make the problem worse.
Bleeding Bleeding may occur when cancer treatment affects the blood and its ability to clot. Areas of gum disease may bleed on their own or when irritated. Small red spots may occur on the lips, soft palate, or bottom of the mouth. Bleeding may be severe, especially around the teeth. Oozing of blood from the gums may occur when blood counts drop below certain levels.