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Mouth & Throat Changes

Because chemotherapy is a systemic treatment and targets rapidly dividing cells, the normal cells in your mouth and throat can be damaged. This might lead to the development of mouth sores, dry mouth, or changes in taste and smell. Also, individuals who receive radiation to the head and neck area may experience mouth and throat changes. Ask your doctor or nurse if you should expect this side effect.

Mouth Sores (Mucositis)

Mucositis is the term for inflammation and/or sores in your mouth, on your lips, or in your throat. When, and if, mouth sores develop and how long they last depends on the treatment you are receiving. If your doctor or nurse has indicated that mouth sores are a likely side effect of your treatment you will want to start good mouth care habits early on in your treatment. If mucositis becomes painful or makes you not want to eat or drink, you may need medication to control the pain. Call your doctor or nurse if you experience pain when eating or drinking.

Dry Mouth

Sometimes chemotherapy and radiation therapy can decrease the amount of saliva in your mouth so that your mouth becomes very dry and your saliva becomes thick. Dry mouth can make it difficult to chew and swallow. If radiation has decreased the amount of saliva in your mouth, the problem may persist after treatment is over. Ask your health care team about saliva substitutes if your mouth is very dry.

Changes in Taste and Smell

Cancer treatment can make food taste like metal or chalk, have no taste at all, or just taste different than before treatment. You may find you no longer enjoy the same foods or tastes that you did before. In most cases, this goes away after treatment is over. Taste and smell are an important part of eating. Changes in your taste and/or smell are commonly temporary, and routinely resolve within three months of treatment completion. If you find that changes in your taste and smell are affecting your eating, tell your doctor or nurse.

Coping with Mouth & Throat Changes

  • Before starting treatment, talk to your doctor about making dentist appointments. It might be necessary for you to have dental work completed prior to treatment if there is a risk of infection, or it might be necessary to avoid routine dental appointments for a specific period of time after treatment is completed.
  • Check your mouth and tongue every day for mouth sores, red areas or white patches. White patches may indicate infection.
  • Drink plenty of fluids, chew gum or suck on hard candies to keep your mouth moist.
  • Brush with an extra-soft toothbrush and use fluoride toothpaste.
  • Avoid mouthwash that has alcohol because it can dry out your mouth. 
  • Avoid sharp, crunchy, spicy or citrus foods, alcoholic beverages and tobacco when your mouth is sore.
  • Eat cool or room temperature foods and foods that are soft and easy to swallow, like cooked cereals, soft-boiled or scrambled eggs, yogurt and puddings.
  • Ice chips or popsicles may reduce pain, but tell your doctor or nurse if you need pain medication for your mouth sores.
  • If changes in taste and smell affect your ability to eat, ask your doctor for a referral to a nutritionist who can help

Coping with Dry Mouth

Food Tips for Dry Mouth:

  • Make sure you drink enough fluids to prevent dehydration. Carry a water bottle with you to stay hydrated.
  • Increase your saliva by:

    • Sucking on sugar free tart candies prior to eating

    • Chewing on sugar free gum in between meals

    • Moistening foods with sauces and gravies

  • If acidic foods don't irritate your mouth or throat, you can also try:

    • Adding lemon or lime to water

    • Using cirtrus fruits or juices in marinades or dressings

  • Limit dry or hard-to-swallow foods, such as baked potatoes, peanut butter, tough meat, and "doughy" bread.

  • Avoid alcohol and limit caffeinated drinks.

Non-Food Tips for Dry Mouth:

  • Use alcohol-free mouthwash daily and/or salivia substitutes
  • Apply lip balm or petroleum jelly to protect your lips.
  • Sleep with a humidifier in your room to help moisten your mouth at night. Be sure to clean the humidifier regularly. 

Changes in Taste and Smell

If everything tastes bland or has no taste:

  • Add stronger flavors onto foods. If you don't have mouth or throat sores, pickles, condiments, sauces, dressings, vinegar, or cirtrus juices may help.
  • Add spices and seasonings to enhance the flavor of your food.
  • Marinate meats for a stronger flavor.
  • Suck on sugar free tart candies before or after a meal. 
  • Clean your mouth with homemade baking soda rinse (see page 8).

If everything tastes metallic or bitter:

  • Choose other protein sources (such as fish, chicken, or beans) if red meat tastes metallic.
  • Use plastic utensils instead of silverware.
  • Add sweeteners such as honey or pure maple syrup onto foods to offset the bitter taste.

If the smell of food makes you not want to eat:

  • Avoid being in the kitchen when food is being made.
  • Open a window or turn on a fan to minimize the smells.
  • Choose cold or room-temperature foods instead of hot foods, which can smell stronger.
  • Light a pleasant scented candle or essential oil diffuser to remove offensive odors.

If you don't want to eat sour or sweet foods:

  • Try more savory foods or use herbs, spices, and seasonings (such as onion, garlic, basil, oregano, rosemary, tarragon, barbecue sauce, mustard, ketchup,or mint) as tolerated.

Try these recipes if you experience mouth pain: Almond Banana Wheatberry Cereal RecipeAvocado Macaroni and Cheese RecipeBanana Melon Smoothie RecipeChicken, Broccoli, and Noodle Casserole RecipeRoasted Cauliflower Soup RecipeGolden Milk Popsicle Recipe, and Mango Lassi Overnight Oats Recipe

Try these recipes if you experience dry mouth: Cranberry Coconut Popsicle RecipeHerbed Lemon Salmon RecipeCheesy Chicken Millet Bake RecipeChicken Puttanesca over Zucchini Noodles RecipeGolden Milk Popsicle Recipe, and Turkey and Barley Vegetable Soup Recipe

Try these recipes if you experience changes in taste: Creamy Beet Hummus RecipePolenta with Fruit Compote Recipe & Savory Stuffed Spaghetti Squash Recipe