Mouth

Inflamed Mouth and Gums

Your mouth, gums become inflamed more easily. Reduced saliva production also causes overall dryness of the oral tissues and also increases your risk of developing tooth decay.  I increased my visits to the dentist for check-ups and appointments with my dental hygienist (every 4 months) in order to minimize the risk of developing oral infections, inflamed gums, etc. Periodically I suffered from mouth sores.  See your dental hygienist or dentist if you have recurring issues of this nature.

Recommendations

• ¼ teaspoon baking soda, ⅛ teaspoon salt in 1 cup of warm water; rinse often or gargle. Do not swallow for sore mouth, sore throat.

• Use Biotene mouth rinse and chewing gum to help stimulate saliva.

• Biotene toothpaste.

• Use an ultra soft toothbrush. Allow the brush to dry out between brushings. Wash your toothbrush with a mild soap periodically and change your brush frequently.

• Floss or use a small conical brush to clean in between your teeth regularly.

• Periogard mouth rinse (chlorhexidine): use after meals and after cleaning teeth if you're undergoing chemotherapy.

• Chewing a sugar-free gum can help stimulate saliva.

Mouth Ulcers / Mucositis

Chemotherapies, as well as other treatment approaches, can cause these quite painful conditions and may keep you from eating. The second and third recommendations are first steps and are by prescription. Further aid is available, but you should see a physician / dentist / hygienist to manage these conditions.

Recommendations

• Magic Swizzle Sticks from hospital pharmacy.

• 50% Kaopectate and 50% Benadryl: use as needed 10 minutes prior to eating to relieve oral pain.

• 2% Viscous Lidocaine and diprehydranine (Benedryl) elixir 12.5 mg and Maalox in three equal measures.

Taste Distortion Issues

Some treatment regimens can distort or cause strong flavors (ie metallic or bitter) that make eating or drinking a challenge. Taste distortion can become a real issue with staying hydrated. My targeted therapy periodically caused a strong and bitter quinine-like flavor that made drinking fluids distasteful. I suspect with certain therapies, this taste distortion can be more pronounced if you're even slightly dehydrated.

Recommendations

• Hydration is important……DRINK DRINK DRINK!!! 

• Avoid caffeine or other fluids that can contain natural diuretics.

• Lemon water or water with fresh mint or cucumber slices helps make water more palatable.

• Diluted juices such as orange juice or apple juice work well.

• Bubbly water, La Croix, Spindrift

• Fresh Coconut Water contains electrolytes and potassium.

• Gatorade is helpful for electrolyte replacement, as is G2, which is lower in sugar.

• Oral rehydration mix (electrolyte balanced), is an option. You can mix it with juice (ie cranberry) to mask its taste.

• Citrus popsicles.

• Jello. Brothy soups.

Esophagitis

Radiation near the esophagus can also cause esophagitis, making it painful to swallow.  It can also cause inflammation of the esophagus, making it very difficult to swallow large or solid items. 

Recommendation

For radiation near the esophagus: mix 2 teaspoons of L-Glutamine with a thick juice, like apricot or pear nectar, to  help prevent esophagitis. Take daily a week before treatment and during treatment  as it can be quite effective in help[ing protect that area.

Salivary Gland Protection for Radiation

For proactive salivary gland protection, radiation patients should take Salagen as it helps 40% of patients to stimulate salivary flow. This prescription medication takes 12 weeks to work but it has been shown to have a radioprotective effect on salivary glands. Check with your physician before using Salagen to confirm it is not contraindicated with your treatment regimen.

Recommendations

• Take Salagen, 5 mg twice a day.

• Copious amount of water may be needed. 

• Optimoist spray or Xeroluable; supplement with saliva substitutes.

• Sugar free gustatory supplements can also be used. I found Jolly Rancher has decently tasty non sugar hard candies. There were four flavors and they came packaged as a mixed bag.