If you undergo chemotherapy or radiation therapy, you may experience some unwanted side effects. Mucositis is a common side effect of these therapies. But it can also occur in people with weakened immune systems from causes other than cancer.
Mucositis, painful and sometimes debilitating, is the inflammation of the tissues that line the inside of the mouth, part of the mucous membrane. According to research published in the journal Translational Oncology, mucositis occurs in 40 per cent of people undergoing chemotherapy and up to 100 per cent of people undergoing treatment for head and neck cancer.
Fortunately, with oral care and other methods, the pain and discomfort of mucositis can be lessened. Knowing how mucositis develops, its symptoms, and its health risks can help you understand when to treat and manage it.
Mucositis: Causes and symptoms
Chemotherapy drugs attack cancer cells, but they can also attack healthy cells. Unfortunately, neither chemotherapy nor radiation therapy distinguishes between cells.
Cancer therapies can attack healthy cells in the mouth lining, among others. The tissue becomes fragile to ulceration or infection from mucositis in the face of aggression, according to The Oral Cancer Foundation. Also, weakened immune systems are less resistant to mucositis.
Mucositis usually appears within 5 to 10 days after starting chemotherapy treatment. The symptoms are mainly:
- Red, swollen or sore mouth
- Mouth sores (ulcers or lesions)
- bleeding in the mouth
- pus in the mouth
- More oral mucus and thicker saliva
Other oral tissues, such as the gums or tongue, may also be affected.
These symptoms can make eating difficult because of pain and even actions such as swallowing or talking. Mucositis is also the cause of intolerance to food and drink, leading to malnutrition and dehydration.
Also, be aware of a form of mucositis, lichenoid mucositis, which has similar symptoms but no known cause.
Mucositis: Approach and treatment options
Before starting anti-cancer therapy or treatment that may weaken the immune system, consult your dentist to learn how you can help control and treat the symptoms of mucositis and reduce the risk of severe mucositis. Your dental professional may recommend several home therapies or medications as treatments for oral mucositis.
Home remedies for oral mucositis
Ice cubes: Sucking on, not chewing on, ice cubes before and after each treatment session helps protect tissues. (For added flavour, you can suck on frozen fruit.)
Saltwater rinses: Using saltwater rinses in your oral care routine can also help prevent or reduce the severity of mucositis.
Changes in diet: Avoid spicy, salty, acidic, caffeinated, dry or hot foods, as they can irritate damaged tissues.
The Stanford Cancer Center recommends bland, non-irritating foods such as milk or fruit smoothies, puddings, oatmeal, pasta, and mashed potatoes. Soft, high-protein foods like yoghurt are a good choice.
Eating fruits without seeds and with high water content is advised, and pureeing foods such as vegetables and fruits can also make eating easier.
Foods dipped in olive or canola oil can help you eat small bites by gliding better.
Beverage options: Stay hydrated by frequent fluid intake, especially water. Hot decaf tea can be a calming drink. Avoid caffeinated and alcoholic beverages.
Oral care: Avoid alcohol in your mouthwash, so choose an alcohol-free product.
Maintaining a routine for your mouth care is vital for your overall health. Brush your teeth after every meal or snack with mild fluoride toothpaste and a soft-bristled toothbrush. Being as gentle as possible, floss once a day.
Avoid any tobacco product in the mouth, that is, neither smoking nor chewing.
One more thing: Your dentist may suggest a solution known as magic mouthwash, which contains a mix of over-the-counter or prescription numbing ingredients, antacids, antibiotics, antihistamines, or antifungals. (It is a mixture as magical as it is thick.)
Medications for the treatment of mucositis
Your dentist may prescribe medication if home remedies are not enough to relieve pain and discomfort. For example:
- Mouthwash with a numbing agent to help numb the inside of the mouth.
- Topical anaesthetics in gel or spray form to numb sore areas of the mouth.
- Benzydamine or corticosteroids to relieve mouth pain.
- Mucous protectors protect the lining of the mouth and nerve endings.
- If necessary, prescriptions for more powerful painkillers.
- If you are undergoing head or neck chemotherapy, seek a dentist specialising in cancer care for additional guidance. Ask your oncologist or the doctor who treats you about other methods and medications approved by the health authority that can protect you from mucositis.
The excellent news: Mucositis usually goes away on its own when treatment is withdrawn. It can take two to four weeks with chemotherapy or eight weeks with radiation therapy.
Especially when you already suffer from other major health problems, the appearance of mucositis is not fair at all. Talk to your dentist and other health professionals about how to treat mucositis and control its symptoms before starting any therapy. You will be doing your mouth a great favour.