Chronic GVHD often affects the mouth and salivary glands. Symptoms may include:
- redness and lacy white patches in the mouth, often on the tongue and cheek
- painful sores anywhere in the mouth or on the lips
- painless, small fluid-filled lesions that come and go throughout the day
- sensitivity to spicy, acidic or crunchy food, carbonated beverages and mint-flavored toothpaste
- a very dry mouth
- changes in taste
- difficulty eating or swallowing food
Chronic GVHD in the mouth is usually treated with:
- a topical steroid gel or cream such as fluocinonide or clobetasol gel
- an oral rinse containing dexamethasone, budesonide or prednisolone
- tacrolimus either as a rinse or topical treatment
- pilcarpine and cevimeline
Some over-the-counter products can help stimulate saliva such as Biotène® dry mouth toothpaste and mouth wash, Mouth Kote® or Biotène® oral moisturizing spray, Xylimelts® and Sparx® xylitol candies.
Medications such as lidocaine or magic mouthwash may be prescribed to control pain.
A dietitian can help you plan meals that avoid foods that may cause pain.
- Tell your doctor right away if you have symptoms of chronic GVHD in your mouth.
- Since a lack of saliva can lead to tooth decay, it is important to practice good brushing and flossing.
- See a dentist twice a year for a thorough cleaning and check-up. Ask your dentist if you need a fluoride prescription or in-office fluoride varnish therapy to prevent cavities.
- Patients with oral chronic GVHD have an increased risk of developing cancer in their mouth. You should be checked annually, preferably by a specialist who is familiar with both GVHD and oral cancer, to examine any unusual lesions. You can find a doctor who specializes in oral GVHD in BMT InfoNet’s online GVHD Directory at bmtinfonet.org/gvhd-directory.
- GVHD in your mouth can make eating difficult. Order the free brochure Eating Well, Living Well after Transplant at bmtinfonet.org/eat-well or phone 888-597-7674.
Watch the video about Oral GVHD. Click here to read the transcript and download the slides.
If you use social media, learn more about living with graft-versus-host disease and advances in treatment at #GVHD. Connect with others and show your support for GVHD patients.
(To view this page in Spanish click here.)
Next page: Lungs and GVHD
Updated August 2022