Version May 2024
| Intervention | Basic oral care plan |
| Flossing | Floss at least once daily. |
| Waxed floss may be easier to use and minimize trauma to the gingivae. | |
| If flossing causes bleeding of the gums that does not stop after 2 minutes, consult your oncology team. | |
| Brushing | Use a small, ultra-soft-headed, rounded-end, bristle toothbrush (an ultrasonic toothbrush may be acceptable).* |
| Use prescription-strength fluoride toothpaste; spit out the foam but do not rinse mouth. | |
| Use remineralizing pastes and chewing gum containing calcium and phosphate. | |
| Brush within 30 minutes after eating and before bed; ensure the gingival portion of the tooth and periodontal sulcus are included. | |
| Rinse toothbrush in hot water to soften the brush before using. | |
| Brush tongue gently from back to front. | |
| Rinse brush after use in hot water and allow to air dry. | |
| Change toothbrush when bristles are not standing up straight. | |
| For patients with dentures | Remove dentures, plates, and prostheses before brushing. |
| Brush and rinse dentures after meals and at bedtime. | |
| Remove from mouth for long periods (at least 8 hours per 24 hours) and soak in rinsing solution. | |
| Rinsing | Rinsing the oral cavity vigorously helps maintain moisture in the mouth, removes the remaining debris, and reduces the accumulation of plaque and infection. |
| Patients should rinse, swish, and spit with a bland rinse (1 teaspoon salt and 1 teaspoon baking soda in 4 cups of water) several times a day. | |
| Club soda should be avoided because of the presence of carbonic acids. | |
| Commercial mouthwashes with alcohol base or astringent properties are not recommended for patients with oral complications. | |
| Debriding should only be done if absolutely necessary, if tissue is loose causing gagging or choking. | |
| Moisturizing the oral cavity | Moisturize the mouth with water or artificial saliva products or other water-soluble lubricants for use inside the mouth. |
| Avoid glycerin or lemon-glycerin swabs as they dry the mouth and do not moisturize. | |
| Apply lubricant after each cleaning, at bedtime, and as needed. | |
| Water-based lubricant must be applied more frequently. | |
| Frequent rinsing as needed with basic mouth rinse. | |
| Lip care | To keep lips lubricated and moisturized, use only animal or plant-based oils such as beeswax, cocoa butter, and lanolin. Avoid petroleum-based products as these will cause drying and cracking. |
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