Dry mouth, painful mouth and mouth ulcers are caused by infections, drugs, chemotherapy, trauma, dryness,
radiotherapy, HIV and opportunistic infections.
MANAGEMENT
Non-medicine treatment
- Mouth wash with salted water (hourly), frequent sipping to keep mouth moist
- Brush teeth and tongue at least 3 times a day
- Suck fresh cold pineapple cubes once or twice daily
- Avoid sugary foods and drinks, eat soft food
- Apply vaseline to cracked lips
- Review medications (dry mouth can be a side effect, e.g. of amitriptyline)
Treat appropriate infection:
- Candidiasis with fluconazole 200 mg od for 7 days
- Herpes simplex with oral acyclovir 200 mg, 5 times a day for 5–10 days depending on severity
- Anaerobic gingivitis, halitosis, with metronidazole mouthwash (mix 50 mL of IV
metronidazole with 450 mL of water, plus 50 mL of juice)
Severe mucositis or aphtous ulcers
- Consider steroids dexamethasone 8 mg once daily for 5 days
- Analgesic gel (Bonjela, Oracure) on ulcers
Painful mouth
- Oral liquid morphine as above (before swallowing, hold liquid morphine in the mouth
for at least 30 seconds)