Rhode Island Cancer and Oral Health Resource Guide
Understanding Oral Chronic Graft-Versus-Host Disease (Oral cGVHD)
Patients
A guide for patients after bone marrow or stem cell transplant.
What is Oral cGVHD?
After a bone marrow or stem cell transplant, you receive healthy blood-forming cells from a donor. Sometimes these donor immune cells see parts of your body as “foreign” and attack them. This reaction is called chronic graft-versus-host disease (cGVHD). When this happens in the mouth, it is called oral cGVHD. It usually appears 6–24 months after transplant.
Why Does Oral cGVHD Happen?
• Donor immune cells may attack normal tissues in the mouth, including the lining and salivary glands.
• This can cause inflammation, soreness, dryness, or tightness.
• Oral cGVHD can occur even if your donor is a good genetic match.
Oral Signs and Symptoms and How They Affect Daily Life
You may notice:
• White or red patches in the mouth or on the tongue
• Painful sores, including large canker-like ulcers
• Dry or sticky saliva
• Small fluid-filled blisters
• Tightness or stiffness in the mouth or jaw
• Trouble eating, talking, tasting, or cleaning teeth
• Symptoms may come and go, and change over time
• Weight loss or difficulty eating should be reported to your care team
These problems can happen alone or together and can make daily activities like eating, talking, or oral hygiene more difficult.
Possible Complications
• Higher risk of infection, cavities, or gum disease
• Slightly increased risk of oral cancer over time
How Oral cGVHD is Diagnosed and Treated
• Exam and history by your oral medicine specialist or oncologist
• Sometimes a biopsy is needed to confirm
• Symptoms are tracked over time to guide treatment
Treatment Options
• For pain or inflammation: Steroid rinses or gels, numbing gels, non-steroidal creams
• For dry mouth: Drink water often, use over-the-counter saliva products, fluoride gel, MI Paste, prescription medications to stimulate saliva
• For tightness or stiffness: Gentle jaw exercises and massage
Preventing Complications
• Avoid spicy, acidic, hot, or hard foods
• Avoid alcohol, alcohol-based mouth rinses, and strong mint/cinnamon products
Self-Care Tips
• Brush gently with a soft toothbrush and non-mint toothpaste
• Rinse with mild salt and baking soda solution (1 tsp salt + 1 tsp baking soda in 1 quart of water)
• Keep lips moist with non-flavored balm
• Report new or worsening sores to your care team
Key Points to Remember
• Oral cGVHD is common and manageable after transplant
• Symptoms often improve over time with treatment
• Have regular oral exams with an oral medicine specialist or oncologist, at least once a year.
• Taking care of your mouth and avoiding triggers can help reduce flare-ups
For more information about oral GVHD, see these resources:
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Oral Chronic Graft-Versus-Host Disease - The American Academy of Oral Medicine
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Importance of Good Oral Health Before, During, and After Cancer Care​
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The information on the Rhode Island Cancer and Oral Health Resource Guide, including but not limited to, text, graphics, images, and other external materials are for informational purposes only. The Partnership to Reduce Cancer in Rhode Island does not provide medical advice. The information on this website is not intended as a substitute for professional medical advice, diagnosis, or treatment.