Today is Oral Health Day, which should remind us all to be more aware of this area of personal wellbeing.

Often people living with lung cancer have problems with oral health, and it particularly affects those receiving radiotherapy or chemotherapy. In addition, some people on targeted therapy for lung cancer may also experience similar problems.

Some issues you might notice:

• Sores on the lining of your mouth and throat, which can make it hard to eat and drink
• Dry mouth, which can make it hard to swallow and may lead to infections or even tooth decay
• Bleeding or sensitive gums
• Aches and pains in and around your jaw
• Changes in the way food tastes
• Loss of appetite

If you notice any changes in your mouth make sure you report them to your health care team.

What can you do to protect yourself and ease any symptoms?

Having good oral hygiene is important. Keep your mouth clean and fresh, regularly brushing your teeth or dentures with a soft brush.

If it hurts when you brush, you can soften your toothbrush by soaking it in warm water before using it. If toothpaste stings, brush instead with salty water; add a quarter of a teaspoon of salt to two cups of water.

Rinse your mouth out with water frequently. This can help keep food away from your teeth and gums.

Talk to your dentist

It may be a good idea to visit your dentist for a check-up before starting treatment. Don’t delay your cancer care but, if possible, try to see your dentist at least a month ahead, in case your mouth needs time to recover from a dental procedure.

Remember to keep your dentist informed of your diagnosis and throughout treatment.

Infections, such as thrush (white patches over the lining of your mouth or your tongue), or problems with your teeth or dentures can make things worse. If this happens, speak to your GP or hospital and they may prescribe medication to help.

Some people receiving radiotherapy may feel stiffness in and around the jaw muscles. If so, try exercises; three times a day, open and close your mouth as far as you can without feeling pain 20 times.

Eat well; while you may not have as much of an appetite when having treatment, try to keep eating healthy foods to nourish your body. Eat small meals throughout the day instead of two or three bigger meals.

Stay hydrated, as drinking plenty of water can help if you have a dry mouth.

Foods to try – and some you might want to avoid

It is quite common for people to lose their appetite while having chemotherapy. Your sense of taste may also be affected. So, for instance, you might get a metallic taste in the mouth or find you can’t taste anything at all. If you are concerned you’re not eating or drinking enough, you should tell your doctor as there are dietary supplements available on prescription.

The third day after chemo I felt better and wanted something to eat. I didn’t do too much and gradually got back to how I felt before.

KENNY, LIVING WITH LUNG CANCER

Here are some ideas that may help:

Try milkshakes and smoothies, because these are a great way to get fruit and veg into your diet if you are having trouble chewing and swallowing.

Avoid very hot food, as it can irritate your throat. So, let it cool down to a temperature you find works best for you. For instance, this might be room temperature or straight from the fridge.

Suck on ice cubes (don’t chew!) or sugar-free frozen ice-pops, as these can ease mouth sores and a dry mouth. However, chewing or biting into ice cubes can be bad for your teeth and gums.

Try to avoid rough or textured food: Cereal or crackers, for example, can catch in sore areas.

Instead, go for milder foods and avoid curry, chillies, citrus fruit and vinegar.

Try blended, creamy foods: Soups really work for some people, but just remember to let your food cool a bit before eating.

Be wary of alcohol; while a glass of sherry before a meal can help some people’s appetite, alcohol can irritate sore mouths, so avoid it until your mouth feels better.

Smoking and oral health

Stopping smoking is good for anyone. It’s even more important to stop if you have lung cancer and are starting treatment, such as surgery, chemotherapy and radiotherapy.

Tobacco smoke narrows blood vessels, which can reduce the amount of chemotherapy drug reaching the cells. Carbon monoxide replaces oxygen in blood, and this can slow down healing, and reduce the effectiveness of treatments such as radiotherapy.

Smoking can also reduce the effectiveness of many drugs used to manage the side effects of treatments and cancer symptoms. So, treatment is safer and works better for those who have been able to quit smoking.

You can find more information and advice on how to manage lung cancer symptoms on our website and from our online support group.