Mouth and GVHD (Oral GVHD)

Graft-versus-host disease can cause mouth dryness and sores, sensitivity to food and eating difficulties.

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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 in the mouth
  • 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 (Salagen®) and cevimeline (Evoxac®)

Medications such as lidocaine may be prescribed to control pain.

Lack of saliva in the mouth can lead to cavities. It is important to use good brushing and flossing at home, and use prescription fluoride therapy.

Patients with oral 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 look for any unusual lesions in the mouth.

Oral GVHD can make eating difficult. Get tips for managing eating problems after transplant.

Watch a Video about Oral GVHD (60 minutes)

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Next page: Lungs and GVHD