Initial Signs and Symptoms

  • Red, shiny or swollen mouth and gums
  • Soft white patches or pus in the mouth or on the tongue
  • Sores in the mouth, on the gums or on the tongue
  • Blood in the mouth
  • Difficulty swallowing or talking
  • Feeling of dryness, mild burning, or pain in mouth or throat when eating
  • Increased mucus or saliva in the mouth

Risks of Mucositis:

  • Pain
  • Infection: portal of entry for organisms
  • Dehydration/ Malnutrition: restricted oral intake
  • Contributes to interruption of medical therapy
  • May increase use of antibiotics and opioids


  • Ice Chips
  • Systematic approach to oral care to reduce infection, bleeding and microbial flora
  • Some evidence that low level laser Therapy may reduce the incidence


  • Assess the mouth frequently! Rigorous assessment and early intervention is key
  • Rinse mouth well after every meal
  • Texture as tolerated and choose high calorie, high protein fluids
  • Use a soft bristled toothbrush to clean the teeth
  • Avoid foods that irritate the mouth or throat (e.g. abrasive, acidic, salty, spicy etc.)
  • Use of Oral Balance(saliva product)
  • Systemic analgesia with a strong opioid is the recommended treatment for oral mucositis
  • Ice chips or popsicles to numb the area
  • Remove dentures whenever possible and clean thoroughly
  • Patient and family health teaching
  • Use of a gentle rinsing solution (1 tsp. salt, 1 teaspoon baking soda in 1 liter/4cups of water prepared once daily and notrefrigerated)
  • Topical anaesthetics (e.g. viscous lidocaine 2% or viscous xylocaine 2%, 2-5 ml.) before eating and before brushing

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PDF – Mucositis