Mouth Care in Haematology Patients

Cancer treatment is known to cause soreness and dryness in the mouth, along with an increased risk of mouth infections and dental problems. These problems could be mild and resolve within a few weeks after the cancer treatment is over.
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In some cases, the symptoms may become severe and persist for longer, making it difficult for patients to eat food. Hence, it is essential to take proper mouth care and maintain oral hygiene while undergoing treatment for blood cancers.

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Change in taste

Patients undergoing treatment for cancer may develop a change in taste. They may lose the sense of taste completely. Sometimes, the food you usually eat may taste unpleasant. These changes are temporary and typically return to normal within a few weeks after chemotherapy is over.

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Dry Mouth

The salivary glands produce saliva – the moisture in your mouth or spit. Conditions that affect the mouth and salivary glands can result in dry mouth (xerostomia). This can be a troubling side effect in haematology patients and can be caused by a number of factors such as:

• Medications: Chemotherapy, pain medications, anti-depressants
• In patients following allogeneic transplantation – they can develop dry mouth due to oral graft versus host disease (GvHD).
• Radiation therapy can cause dry mouth when the salivary glands have been exposed to radiation.
• Conditions such as dehydration, or fungal infection of the mouth (candiasis)

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Mucositis

Cancer treatments such as chemotherapy target the rapidly dividing cells and destroy them. However, these treatments can also affect the body’s normal cells, including cells lining your mouth called the mucosa.
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During treatment, the mucosa may become thin due to the inability to regenerate or repair itself. It can leave your mouth vulnerable to sores, ulcers, or inflammation that can lead to oral mucositis. If the mucositis is severe, you may require hospital admission.
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The common symptoms of oral mucositis include:

• Ulcers in the mouth, especially on the tongue and lips
• Painful sores that interfere with eating, drinking, and talking
• Foul smelling breath
• Reduced sense of taste
• Dryness in the mouth 

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Oral thrush

This is a type of fungal infection affecting the mouth. It is sometimes called oral candidiasis as it usually occurs due to the yeast or fungi known as Candida.
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The common symptoms of oral thrush include:

• The appearance of white patches in the mouth that leaves behind red sores which may bleed when scraped
• Loss of taste
• Unpleasant taste in the mouth
• Cracks at the corners of the lips
• Redness in the mouth and throat
• Pain and burning sensation in the mouth that can make eating and drinking difficult
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You can speak to our medical team if you experience these symptoms. In severe cases, oral thrush may become worse and spread to other parts of your body.
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Treatment of oral thrush
Oral thrush can be treated using anti-fungal medications. It is important to finish the course of these medicines even after the symptoms have improved..

Mouthwashes and dental gels containing Chlorhexidine Gluconate possess anti-fungal properties. However, these products may interfere with the action of anti-fungal medicines you are using. Hence, you may be asked to not use mouth care products and anti-fungal drugs at the same time. It is advisable to leave a gap of at least 30 minutes between anti-fungal medications and your mouthwashes or dental gels.

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Disclaimer:
The information on the Centre For Clinical Haematology website is intended for educational use.  It should not be considered or used as a substitute for medical advice, diagnosis or treatment from a qualified health professional.