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Mouth and teeth: gentle care every day

Chemotherapy makes the lining of the mouth vulnerable; with low neutrophils, mouth germs can cause infection, and with low platelets the gums can bleed.

Last updated: ~1 min read
Soft toothbrushes in a cup
Figure 1.A soft toothbrush

01Short answer

If possible, see a dentist before treatment; plan this with your team. After every meal and at bedtime, brush gently with an extra-soft toothbrush, softened in warm water if needed. Avoid alcohol-based mouthwashes; use the simple rinse your team suggests (for example water, salt or baking soda solution). Floss only if your team allows it. Clean dentures daily and leave them out if they hurt. Keep your lips moist. Tell your team about white patches, sores, bleeding or pain when swallowing.

02Simple explanation

Extra-soft brush.

After meals.

Alcohol-free rinse.

Changes: tell us.

03Scientific explanation

NCI: chemotherapy and radiation can cause mouth problems; a dental check before treatment and gentle daily mouth care are recommended.

NCI: chemotherapy can lower neutrophils, platelets and red cells, which raises the risk of infection, bleeding and fatigue.

04What happens in the body?

Mucositis

Inflammation of the mouth lining, shown by pain and sores.

Thrush

White patches may be a fungal infection; your team treats it.

The dentist
Figure 3.The dentist — Mouth and teeth: gentle care every day

Neutrophils

The first defence against infection; when they are low, hygiene matters most.

Platelets

Help blood clot; when they are low, protect yourself from injury.

05Daily protection: four steps

Wash, protect, check, report.

Wash — Hands and personal hygiene.1WashHands and personal hygiene.
Protect — Against injury and infection.2ProtectAgainst injury and infection.
Check — Temperature and skin.3CheckTemperature and skin.
Report — Tell your team about changes.4ReportTell your team about changes.
HygieneClean hands.
TemperatureThe 38 °C threshold.
ProtectionYour team's rules.

06Key points at a glance

TopicIn brief
MucositisInflammation of the mouth lining, shown by pain and sores.
ThrushWhite patches may be a fungal infection; your team treats it.
NeutrophilsThe first defence against infection; when they are low, hygiene matters most.
PlateletsHelp blood clot; when they are low, protect yourself from injury.

07Key terms

Mucositis
Inflammation of the lining of the mouth and throat.
Candidiasis
A fungal infection, often a white coating.
ANC
Absolute neutrophil count.
Thrombocytopenia
A low platelet count.

08Key points

  • Brush gently.
  • Rinse alcohol-free.
  • Tell us.
  • Wash your hands.
  • 38 °C: call.

09Frequently asked questions

Can I floss?

Only if your team allows; it is usually paused when platelets are low.

My mouth is dry.

Sip often, moisturise your lips and tell your team.

What should I watch every day?

Temperature, bleeding, tiredness and the catheter site; tell your team about any change.

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. My mouth is dry.

  3. What should I watch every day?

My questions

12Sources

  1. National Cancer Institute. Mouth and Throat Problems and Cancer Treatment
  2. National Cancer Institute. Infection and Neutropenia during Cancer Treatment
  3. National Cancer Institute. Bleeding and Bruising (Thrombocytopenia) and Cancer Treatment
  4. National Cancer Institute. Anemia and Cancer Treatment
  5. World Health Organization. World Hand Hygiene Day
  6. Macmillan Cancer Support. Work and cancer
  7. American Cancer Society. Physical Activity When You Have Cancer
  8. Cancer Research UK. Exercise guidelines for people with cancer
  9. NHS. Falls
  10. NHS. Balance exercises
Medical disclaimerThis information is for educational purposes only and does not replace medical advice.
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