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Immunity and infection prevention

Mouth and teeth

The main article (“Hand hygiene and your home”) gives the basics of protection. This topic looks closely at the mouth: mucositis, tooth care and working with a dentist.

Last updated: ~1 min read
A brush next to a glass of water.
Figure 1.A very soft toothbrush.

01Short answer

The mouth is full of bacteria and fungi, and chemotherapy can damage its lining (mucositis). This causes painful sores and opens a gate for infection. Daily care: brush gently twice a day with a very soft toothbrush, rinse after meals with water or a salt or baking-soda rinse your team recommends, avoid alcohol mouthwashes, and keep your lips moist. When platelets are very low, ask your team about brushing and flossing. If possible, have a dental check before treatment so sources of infection can be dealt with in advance. White patches in the mouth may be a fungal infection.

02Simple explanation

Mucositis: damage to the mouth lining.

A soft brush and rinsing.

A dental check before treatment.

03Scientific explanation

Mucositis: the NCI notes that mouth problems are a common side effect of chemotherapy and a source of both pain and infection.

Dental sources: untreated tooth and gum infections can lead to bloodstream infection during neutropenia.

04What happens in the body?

A soft brush

A very soft brush cleans without hurting the gums.

Rinsing

A simple rinse after meals keeps the mouth clean.

A cup on the edge of a sink.
Figure 2.A simple rinse — Mouth and teeth

The dentist

A check before treatment removes sources of infection.

A calm dental chair.
Figure 3.A dental check before treatment.

05Daily mouth care

Four steps.

Brush — With a soft brush.1BrushWith a soft brush.
Rinse — After meals.2RinseAfter meals.
Look — Check your mouth.3LookCheck your mouth.
Report — Mention any sores.4ReportMention any sores.

06Mouth problems

ProblemWhat to do
Painful soresTell your team, ask about pain relief
White patchesMay be fungal; show them
Bleeding gumsHave platelets checked
Dry mouthDrink water, moisten lips
ToothacheA dental check agreed with your haematologist

07Key terms

Mucositis
Inflammation and sores of the lining.
Candidiasis
Infection with Candida yeast.
Gums
The tissue around the teeth.
Mouth rinse
A liquid for rinsing the mouth.
Xerostomia
A dry mouth.

08Key points

  • The mouth can be a gate for infection.
  • Use a very soft brush.
  • Avoid alcohol mouthwashes.
  • See a dentist before treatment.
  • Show any white patches.
  • Agree dental treatment first.

09Frequently asked questions

Can I floss?

If platelets and neutrophils are low, ask your team.

I wear dentures; what should I do?

Clean them daily, take them out at night, and say if they rub.

Pain stops me eating; what can I do?

Tell your team; pain relief and soft foods can help.

10Questions for your doctor

Take these questions to your appointment. The ones you save are collected on the “My questions” page and stay on this device only.

  1. Can I floss?

  2. I wear dentures; what should I do?

  3. Pain stops me eating; what can I do?

My questions

12Sources

  1. MedlinePlus (U.S. National Library of Medicine). Mouth and Teeth
  2. National Cancer Institute (NCI). Mouth and Throat Problems during Cancer Treatment
  3. National Cancer Institute (NCI). Infection and Neutropenia during Cancer Treatment
  4. Cleveland Clinic. Monocytes: Function, Range & Related Conditions
  5. Nature Reviews Immunology, 2014. Ginhoux F, Jung S. Monocytes and macrophages: developmental pathways and tissue homeostasis
  6. Blood, 2017. Grever MR et al. Consensus guidelines for the diagnosis and management of patients with classic hairy cell leukemia
  7. National Cancer Institute (NCI). NCI Dictionary of Cancer Terms: antigen
  8. National Cancer Institute (NCI). NCI Dictionary of Cancer Terms: antibody
  9. National Cancer Institute (NCI). NCI Dictionary of Cancer Terms: immunoglobulin
  10. National Cancer Institute (NCI). NCI Dictionary of Cancer Terms: hypogammaglobulinemia
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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