Oral mucositis is tissue swelling and irritation in the mouth. Radiation therapy or chemotherapy may cause mucositis. Follow your health care provider's instructions on how to care for your mouth. Use the information below as a reminder.

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When you have mucositis, you may have symptoms such as:

• Mouth pain
• Mouth sores
• Infection
• Bleeding

With chemotherapy, mucositis heals by itself when there is no infection. Healing usually takes 2 to 4 weeks. Mucositis caused by radiation therapy usually lasts 6 to 8 weeks, depending on how long you have radiation treatment.

Take good care of your mouth during cancer treatment. Not doing so can lead to an increase in bacteria in your mouth. The bacteria can cause infection in your mouth, which can spread to other parts of your body.

• Brush your teeth and gums 2 or 3 times a day for 2 to 3 minutes each time.
• Use a toothbrush with soft bristles.
• Use a toothpaste with fluoride.
• Let your toothbrush air dry between brushings.
• If toothpaste makes your mouth sore, brush with a solution of 1 teaspoon (tsp) or 5 grams (g) of salt mixed with 4 cups (c) or 1 liter (L) of water. Pour a small amount into a clean cup to dip your toothbrush into each time you brush.
• Floss gently once a day.

Rinse your mouth 5 or 6 times a day for 1 to 2 minutes each time. Use one of the following solutions when you rinse:

• 1 tsp (5 g) of salt in 4 c (1 L) of water
• 1 tsp (5 g) of baking soda in 8 ounces (oz) or 240 milliliters(ml) of water
• 1 tsp (5 g) of salt and 1 tsp (5 g ) of baking soda in 4 c (1 L) of water

Don't use rinses that have alcohol in them. You may use an antibacterial rinse 2 to 4 times a day for gum disease.

To further take care of your mouth:

• Don't eat foods or drink beverages that have a lot of sugar in them. They may cause tooth decay.
• Use lip care products to keep your lips from drying and cracking.
• Sip water to ease dry mouth.
• Eat sugar-free candy or chew sugar-free gum to help keep your mouth moist.
• Stop wearing your dentures if they cause you to get sores on your gums.

Ask your provider about treatments you can use in your mouth, including:

• Bland rinses
• Mucosal coating agents
• Water-soluble lubricating agents, including artificial saliva
• Pain medicine
• "Magic mouthwash" (a mouthwash to help treat mouth sores, available with a prescription)

Your provider may also give you pills for pain or medicine to fight infection in your mouth.

Doroshow JH. Approach to the patient with cancer. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 164.

Majithia N, Hallemeier CL, Loprinzi CL. Oral complications. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 40.

National Cancer Institute website. Oral complications of cancer therapies (PDQ) - health professional version. www.cancer.gov/about-cancer/treatment/side-effects/mouth-throat/oral-complications-hp-pdq. Updated February 16, 2024. Accessed May 29, 2024.