Chemotherapy can cause oral problems in several different ways. Firstly it can lead to inflammation of the lining of the mouth (the lining of the mouth is called the mucosa and inflammation of the mucosa is called mucositis). This may show itself either as a general soreness in the mouth or by the development of painful ulcers on the lining of the mouth and tongue. Secondly, because it can reduce your immunity, chemotherapy may lead to infections in the mouth. The commonest of these is a fungal infection called thrush (also known as candidiasis or moniliasis). This usually appears as white patches, or a white coating over the lining of the mouth and tongue. Chemotherapy can also sometimes lead to a dry mouth and occasionally some bleeding or ulceration of the gums may develop.

Various treatments can be given for all these problems so do discuss your symptoms with your doctors and nurses so that they can decide on the cause of your discomfort and recommend what needs to be done.

Inflammation and ulceration can often be eased by regular use of a mouthwash, twice a day. Suitable mouthwashes include chlorhexidine (Corsodyl or Peridex) and Kamilloson rinse (prepared from extracts of the camomile plant. Benzydamine mouthwash (Difflam) has also proved to be particularly effective for easing the discomfort caused by oral inflammation. Sucralfate is another compound that has been shown to help control mucositis during chemotherapy. Some 'over the counter' mouthwashes contain alcohol among their ingredients and these should be avoided as they might increase any tendency to inflammation.

Rinsing your mouth and gargling with either soluble aspirin solution or a preparation called Mucaine (which your doctor can prescribe) may help to ease the discomfort of inflammation.

There are reports that sucking a tablet called prostaglandin, four times day, helps mucositis to heal, so ask your doctor about this if these other measures have not eased things for you.

If your medical team find you have thrush then this can normally easily be cleared with antifungal medicines like nystatin, which they will prescribe for you.

Usually any oral soreness settles between courses of chemotherapy. If you have developed problems then there are things you can do to try and help them happening again with future courses.

First of all do keep up your oral hygiene with regular brushing of your teeth after every meal. You may find it more comfortable to change to a softer toothbrush for this. Also you may find brushing with chlorhexidine mouthwash more comfortable than using ordinary toothpaste

Smoking, alcohol (especially spirits) and very spicy foods can all make the mucosa (the lining of the mouth) more sensitive and so do try and avoid them or cut them down during your treatment. Also cutting back on very sweet and sugary foods or drinks will reduce the risk of dental problems during and after your chemotherapy.

With some chemotherapy drugs sucking ice chips for five to ten minutes before the drug is given and for half an hour afterwards can also help prevent further mucositis and ulceration. Ask your nurses and doctors if this might be helpful with the drugs you are going to have.