Hello,
This may seem a minor issue all things considered, but I wanted to post up in case anyone has some advice. I've had treatment for tonsillar carcinoma with metastases to my right lymph node in my neck. My treatment was radiation (33 sessions) with 3 rounds of chemo (Cisplatin) only. My treatments ended about two months ago. I've had no surgery.

As a result of the radiation, my salivary glands have been inhibited and my mouth is dry; this is a common side effect of this treatment.

In my case, my tongue is dramatically coated, I believe as a result of the dry mouth. I've tried brushing it, scraping it, and (based on a web search) coating it in salt. These approaches have sort of helped, but the coating comes back.

Has anyone else dealt with this particular set of circumstances? Does anyone have a suggestion for dealing with a heavily coated tongue in a dry, post-radiation mouth?

Thank you,
-Seth

Hi Seth,
I finished IMRT radiation treatments for tongue cancer one month ago today and did not have problems with dry mouth. I did have some trouble with thrush and was treated with oral antibiotics. You may want to ask your RO to write you a scrip just in case.

Barb

Actually if you did have a Candida infection that is a fungal infection, not bacterial, so you were treated with antifungals, not antibacterials. Probably the most common one which is Diflucan, though there are others. Not being critical, just correcting things incase a future reader follows this thread.

As to the original question if you can scrape off that white/tan coating with a fingernail and it is kind of red sore underneath, that is likely Candida albicans. Please point it out to your doctors. The treatment takes about a week of pills, and sometimes a mouth rinse. Please have someone take a look at this, when it gets out of hand for too long it is really hard to turn around.

The dry mouth is likely going to be with you for a long time. I use the Biotene products, toothpaste, mouth wash, gum etc. available from everyone from WalMart to Walgrens. Some like others. But you need to also address this since it can lead to periodontal issues, and you don't want to come through all this just to have rampant gum disease at the end of things. 12 years after the fact, a water bottle is as natural a part of my hand as a watch or a wedding band.

I had thrush twice post Tx and had to take Diflucan. It was pretty painful at times but the meds takes care of it.

I found my oncology dentist to be more familiar with the coated tongue issues than my CCC team but that's why they recommended him to me. I've used diflucan pills, nizoral rinses as well as Mycelex (clotrimazole) troches for this recurrent problem and like the Mycelex the best so far. This is not really a DIY issue, so see a dentist or doctor and get a script.
Charm

My dental hygenist realized it was Thrush after the oncologist tried to give me morphine for the pain. Diflucan cleared it up in several days. There is a study now (I do not have the link) researching accupuncture to increase saliva after radiation. You may search the news articles on this site (it's were I read about it). Accupuncture worked very well for me and re leaved my dry mouth immediately. I'm not a salesman but I am a believer in whatever works for you. Best of luck.
mark

Thanks everybody. Hm, I had my OC look at my tongue when it first became dramatically coated and he did not think it was thrush. It's only on the surface of my tongue; nowhere else in my mouth, and doesn't seem to be progressing in any way. I have some canadian antifungal lozenges called Dequadin (sp?) that I think I'll try. But, I think it's just a badly coated tongue?

My dentist sold me a large bottle of xylitol-sweetened mints (xylitol doesn't promote cavities), and these have turned out to be fantastic, helping wet my mouth and throat while I'm out and about. But yes, travelling with a water bottle has become part of life.

-Seth

I get a coated tongue but it sure isn't white but more the color of dried blood. I have been getting it for close to 3 yrs and it hasn't improved a bit yet. Hurts like it looks too. Like hell. I am now going thru a stage where my mouth id arrid dry and then later it can become hurricane wet. But as they say, Hey man I am alive and breathing with a TOOTHLESS SMILE.