Mouth Sores

THE FOLLOWING TIPS WERE COMPILED BY EDEN STOTSKY-HIMELFARB, BSN, RN

Pain can be a significant problem.  We divide the discussion into tips for when you have a mild case of pain and when you have a more painful situation.

Tips to consider if you have a mild case of pain:  

• Continue brushing with a soft bristle toothbrush after every meal. If you find it too painful to brush, ask your doctor or nurse what you may use.
• Rinse your mouth often with a solution of one teaspoon baking powder and one teaspoon salt, diluted in a glass of lukewarm water. Don't use commercial mouthwashes containing alcohol.        
• Eat foods cold or at room temperature. Hot and warm foods can irritate a tender mouth and throat.
• Choose soft, soothing foods, such as ice cream or milkshakes.
• Try easy to eat foods such as baby food, pureed or minced food, soft fruits (like bananas and applesauce), mashed potatoes, cooked cereals, soft-boiled or scrambled eggs, cottage cheese, macaroni and cheese, custards, puddings, and gelatin. (You also can puree cooked foods in the blender to make them smoother and easier to eat.) For additional foods that are easy to swallow, see the next section.
• Avoid:
  • Irritating, acidic foods, such as tomatoes, citrus fruit, and fruit juice (orange, grapefruit, and lemon) 
  • Spicy or salty foods
  • Rough, coarse, or dry foods such as raw vegetables, granola, and toast.
  • Mouthwashes that contain salt or alcohol.
• If there is pain, the following remedies help relieve the pain. They do not cure the difficulty. 
  • Consider using a topical product to relieve pain.
  • Ice pops, water ice or ice chips may help numb the area. 
  • Dab milk of magnesia  on sores to temporarily soothe their pain. Experts at the National Institutes of Health (NIH) suggest first dabbing the sore witha mixture of half water and half hydrogenperoxide, then dabbing on the milk of magnesia. 
  • Milk of magnesia can be mixed with an equal amount of liquid Benadryl to make a mouth rinse to help coat tissues and relieve pain.

Tips to consider if you have more than a mild case of pain

Ask your doctor if there is anything you can apply directly to the sores and if he or she can prescribe medicine you can take to ease the pain. Topical pain relievers (medicines that relieve pain in a particular area instead of the entire body) include lidocaine, benzocaine, dyclonine hydrochloride (HCI) and Ulcerease. Issues to consider when considering topical agents are:

• Topical agents do not effectively coat all areas 
• Pain relief is brief

If you do not obtain relief from mouth sores with topical treatments, narcotic analgesia is often necessary. This may require admission to a hospital for intravenous (IV) pain medications until the sores begin to heal, particularly if you are unable to swallow. It is important to note that this side effect is temporary and the use of narcotics for the relief of this pain will be temporary as well (and will not cause addiction). 

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