Taste changes and disorders and sore mouth

To prevent and relieve unpleasant side effects in the mouth, it is generally advisable to:

• Maintain proper oral hygiene: during breast cancer treatment, it’s important to keep your teeth and gums clean and hydrated at all times. Your healthcare team may do a dental check-up before the start of treatment and advise you on a hygiene routine and a suitable (alcohol-free) mouthwash.  For example, you can mix one teaspoon of baking soda, one teaspoon of salt and four cups of water to create a homemade mouthwash;
• Stay well hydrated. Dehydration can aggravate dry mouth, oral discomfort and taste issues. To help you stay well hydrated, we encourage you to consult our educational capsule on hydration during breast cancer treatments. It is also important to remember to moisturize the lips by applying an effective lubricant..

NB: Erreur assez majeure sur la page anglaise : le mot anglais est “hydration” et non “hydratation”. Aussi Le bouton en haut de la page devrait se lire “Inform me” et non “Informe me.”

• Adopt and maintain wholesome lifestyle habits: as far as possible, it is advisable to eat a healthy and appropriate diet, and avoid or limit smoking and alcohol consumption.

The following are other tips for preventing or alleviating certain problems in the mouth. Please remember, however, that everyone is different, and tips that help some people may not work for others.

If your mouth is sore from irritation or ulcers, eating can literally be a pain. Here are a few tips for eating despite the discomfort, and for relieving the symptoms:

• Adjust food texture to your level of discomfort: opt for foods that are easy on the mouth, such as well-cooked, soft, blended foods with a creamy texture (if necessary, add a small amount of fat, such as butter, cream, oil, etc.);
• Avoid dry, hard foods (e.g., croutons, crackers, etc.), or soften them by adding sauce or soaking them in liquid ( broth, tea, etc.);
• Cut the food into smaller pieces to reduce chewing time;
• If necessary, use a straw for beverages or liquid foods (smoothies, etc.);
• Avoid “irritant” foods: acidic (citrus fruit, tomatoes, vinegar), too salty or spicy (depending on tolerance);
• Opt for cold or room-temperature meals. Heat may aggravate inflammation pain;
• Some people say that certain cheeses or nuts can worsen the pain caused by ulcers;
• Avoid or reduce alcohol and tobacco consumption;
• Maintain proper oral hygiene by keeping teeth and gums clean and hydrated at all times. Rinse your mouth with a suitable (alcohol-free) mouthwash after meals;
• Suck on ice cubes or popsicles;
• Drink small sips of water regularly. We encourage you to consult our educational capsule on hydration during breast cancer treatments.

In the event of significant ulceration or impact on eating, your healthcare team may suggest pain-relieving medication, as well as appropriate nutritional management.

Insufficient saliva production during treatment, also known as xerostomia, causes dry mouth. Saliva plays an important role in the pleasure of eating, the digestion process and oral health. A lack of saliva can lead to difficulties in chewing and swallowing, can cause unpleasant sensations and lost or decreased taste and put people at greater risk of infections, lesions and tooth decay.

Here are a few tips for combatting dry mouth:

• Opt for well-cooked, soft foods;
• Avoid dry, hard foods (e.g., croutons, crackers, etc.), or soften them by adding sauce or soaking them in liquid ( broth, tea, etc.);
• Some people find that acidic foods and liquids (e.g., fresh pineapple, citrus fruit, cranberry juice) can sometimes help stimulate salivation. Avoid these if you have sores;
• Avoid overly salty and spicy foods;
• Chew gum or sugar-free, mentholated candies;
• Avoid or reduce alcohol and tobacco consumption;
• Maintain proper oral hygiene by keeping teeth and gums clean and hydrated at all times. Rinse your mouth with a suitable (alcohol-free) mouthwash after meals;
• Suck on ice cubes or popsicles;
• Drink small sips of water regularly. We encourage you to consult our educational capsule on hydration during breast cancer treatments.

Your healthcare team may also advise you to use artificial saliva to combat xerostomia.

Chemotherapy can damage the taste buds, which are responsible for sensing various flavours. During treatment, some people experience reduced taste (hypogeusia), the appearance of unusual tastes (dysgeusia), or even a total loss of taste (agueusia).  Here are some tips on how to counteract these changes.

In the event of unpleasant tastes:

• Eat cold or room-temperature foods, which often have a more neutral taste;
• Chew gum or sugar-free, mentholated candies;
• If necessary, use a straw for beverages or liquid foods (smoothies, etc.);
• Try other foods or combinations of foods to counteract unpleasant flavours. For example, add condiments such as mustard, spices, herbs, zest, sauces and marinades, etc.;
• Maintain proper oral hygiene by keeping teeth and gums clean and hydrated at all times. Rinse your mouth with a suitable (alcohol-free) mouthwash after meals;
• Gently brush your tongue from back to front with a soft-bristled toothbrush;
• Stay well hydrated. We encourage you to consult our educational capsule on hydration during breast cancer treatments.

In the event of a metallic taste:

• Avoid metal cooking implements and utensils. Instead, use ceramic, bamboo, wooden or reusable plastic utensils;
• Eating dairy products can reduce the metallic taste of certain foods;
• Try different combinations of sweet and tangy ingredients;
• Some people find that acidic foods such as citrus fruit, cranberry juice or pineapple reduce the metallic taste (avoid these if you have ulcers);
• Choose sources of protein other than red meat, or marinate meat in a sweet & sour sauce, fruit juice or yogurt.

In the event of loss of taste:

• Vary food temperatures: flavors can sometimes be more prominent in hot dishes;
• Try other foods or food combinations and add condiments such as mustard, spices, herbs, zest, sauces, and marinades, trying to balance the acid, salty and sweet flavors.

Hygiène buccale, Cancer Care Ontario

La santé de votre bouche et les traitements contre le cancer, Centre hospitalier de l’Université de Montréal (CHUM)

Guide d’information sur les soins d’hygiène de la bouche pour les patients recevant une chimiothérapie contre le cancer, Centre intégré de cancérologie de la Montérégie, 2017

Bien s’alimenter lorsqu’on a le cancer, Société canadienne du cancer