Nutritional tips for a sore mouth

Treatments such as chemotherapy and radiotherapy can damage the lining of the mouth and throat and cause inflammation, sensitivity and pain when eating and drinking.

What can I do?

  • Your doctor can prescribe pain-relieving medications to help make eating and drinking easier.
  • If you have a sore mouth, pureed or liquid food can help. If possible, try foods that need chewing as this stimulates your mouth to produce saliva. This can help with a dry mouth and improve your sense of taste.
  • Try to work out what foods make the problem worse. You may find it helpful to rinse your mouth with water to reduce the pain.
  • Avoid foods that can be painful. Sour milk products such as buttermilk, yoghurt, yoghurt drinks and cottage cheese might be painful. Try tasteless or sweet milk products such as whole milk, chocolate milk, vanilla custard, chocolate custard, whipped cream and coffee or tea with a lot of milk.
  • Fizzy drinks and alcohol can sting, so you may want to avoid these.
  • Acidic fruits and juices can make the problem worse. Try adding custard, cream, or ice cream to desserts.
  • Spicy and salty foods can be painful to eat. Try using herbs to flavour your food instead of spices and salt.
  • Hard foods such as crackers and toast can irritate the mouth lining. Dip hard foods like biscuits or crusty bread in tea, milk, stock, or soup to soften them. You may find adding extra sauce or gravy helps.
  • Very hot or cold foods can make the pain worse. Try serving foods at room temperature.
  • You may find using a drinking straw makes drinking easier. Try using a short straw to reduce the effort needed to suck.
  • Sucking ice chips can temporarily numb the pain, especially during chemotherapy.
  • If you are unable to eat enough due to the pain in your mouth you should talk to your doctor or dietitian. It may make sense to use special medical foods which contain extra protein and energy. These can be powders, drinks, soups, and puddings. Your dietitian can prescribe these.
  • Smoking can make soreness and irritation worse and can also delay wound healing. Try to stop smoking if possible. Ask your doctor for details of local stop smoking services. Or visit the NHS website for further information.
  • Brush your teeth after every meal using a soft toothbrush and fluoride toothpaste. You may find children’s toothpaste is less painful. You can also buy toothpaste that does not taste of anything if you don’t like the taste of mint. If you wear dentures, clean them with a neutral soap. Avoid mouthwash that contains alcohol as this can sting in your mouth. Check the ingredients list on the mouthwash bottle or look for brands that say alcohol-free on the front of the bottle.
  • Rinse or spray your mouth regularly with a saline solution. You can make a saline solution by adding two small, level teaspoons of table salt to 1 litre of lukewarm water. Keep the solution in the refrigerator for no longer than a day. Prepare a new solution every day. Small empty spray bottles can be bought at the pharmacy to fill with saline yourself and to spray frequently, at home and when you are out.
  • Take care of your lips. Use lip balm or Vaseline to keep your lips moist.

Note: if it becomes very difficult to eat or drink anything, your dietitian may suggest tube feeding to help you meet your nutritional needs. This may be given through a tube passed through your nose into the stomach. This is called a nasogastric tube. A tube directly into the stomach is called a gastrostomy.

If your treatment is likely to make it very hard for you to eat or drink, then you may have a feeding tube placed before starting treatment. A feeding tube doesn’t stop you from eating and drinking normally. It’s a good idea to continue to eat and drink for as long as you can. A feeding tube can be a useful supplement to your oral intake if you find eating painful or difficult. Your dietitian will design a feeding plan that will meet your needs and fit in with your daily life as much as possible.

Get more advice on mouth issues during cancer treatment

> Nutritional tips for thickened secretions forming in mouth and throat during cancer treatment

> Nutritional tips for a soft textured diet during cancer treatment

> What can I do if I have a dry mouth during cancer treatment?

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