How can I manage a dry mouth during cancer treatment?
Sip liquids constantly, and keep something in your mouth that makes it produce saliva. The National Cancer Institute puts drinking plenty of liquids first, and there is a specific reason: a dry mouth raises the risk of tooth decay and mouth infections.
Dry mouth is called xerostomia. It happens when radiation therapy to the head and neck damages the salivary glands, and some chemotherapy and immunotherapy drugs harm cells in the mouth, throat, and lips as well.
The things that actually help
Keep water within reach and sip it through the day to keep your mouth wet. Suck on ice chips or sugar-free hard candy. Eat frozen desserts. Chew sugar-free gum. Use a lip balm.
Sugar-free matters here. A dry mouth already raises decay risk, and sugary candy compounds it.
Ask your team about saliva substitutes, medicines that coat, protect, and moisten your mouth and throat. NCI also notes that acupuncture may help with dry mouth, which is unusual for a federal page to say and worth raising if other measures fall short.
Protecting your teeth, because that is the real risk
Dry mouth is uncomfortable. Tooth decay from dry mouth is expensive and can delay cancer treatment. The prevention steps are worth the trouble.
Get a dental check-up and cleaning before treatment starts, and tell the dentist what treatment you are having. Try to get any dental work finished beforehand.
Check your mouth every day for sores or white spots, and tell your doctor or nurse as soon as anything changes.
Rinse throughout the day with a solution of warm water, baking soda, and salt. Ask your nurse to write down the exact recipe recommended for you, since the proportions vary.
Brush your teeth, gums, and tongue gently after every meal and before bed, using a very soft toothbrush or cotton swabs. If you are at risk of bleeding, ask whether you should floss at all.
Call your team when this crosses a line
Mouth problems become serious when they stop you eating and drinking, because that leads to dehydration and malnutrition.
NCI is specific: call your doctor or nurse if you have pain in your mouth, lips, or throat that makes it hard to eat, drink, or sleep, or if you have a fever of 100.5 °F (38 °C) or higher.
Worth flagging: that Fahrenheit and Celsius pair does not quite match, since 38 °C converts to 100.4 °F. MedlinePlus, reviewed more recently than NCI's page, uses 100.4 °F for 38 °C. Ask your own team which number they want you to call about, and treat the lower one as the threshold if you are unsure.
What else may go wrong at the same time
Dry mouth rarely arrives alone. NCI lists the related problems as taste or smell changes, infections and mouth sores, pain or swelling in the mouth called oral mucositis, sensitivity to hot or cold foods, swallowing problems called dysphagia, and tooth decay.
If your mouth is sore, choose soft, wet foods and soften dry ones with gravy or sauce. Blend food or make milkshakes. Ask about numbing lozenges or sprays before meals. Avoid crunchy, salty, spicy, or sugary foods, alcohol, and tobacco.
If taste has changed, cold foods often work better. Marinades and spices help bland food. If red meat tastes strange, switch to chicken, eggs, fish, peanut butter, turkey, beans, or dairy. If food tastes metallic, use plastic utensils and non-metal cookware. Our guide to mouth and throat problems covers the full range, and the piece on what to expect at a radiation therapy session covers head and neck treatment.
Sources
Want the full picture? Read our complete explanation: Mouth and Throat Problems and Cancer Treatment
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