Difficulty chewing can result from pain in the mouth, stiffness or pain in the jaw muscles, or problems with the teeth. Difficulty with chewing meats, fruits, and vegetables can make it hard to eat a nutritious diet. A person who wears dentures may temporarily not use them for chewing because of pain or swelling in the mouth or gums.

Causes

Difficulty chewing can be a result of physical changes to the mouth, jaw, or tongue caused by cancer itself, especially oral and oropharyngeal cancers. Difficulty chewing can also be a side effect of cancer treatment. Potential side effects of surgery, radiation therapy, or chemotherapy that can cause chewing problems include:

• Soreness, pain, or inflammation in the mouth (mucositis)
  
  
• Dry mouth, from radiation therapy, chemotherapy, or other medications, such as some antidepressant and pain medications
  
  
• Gum disease, tooth decay, or tooth loss, which are possible long-term side effects of dry mouth, radiation therapy, or high-dose chemotherapy
  
  
• Infections of the mouth, after radiation therapy or chemotherapy
  
  
• Pain and stiffness in the jaw muscles, either as a possible long-term side effect of radiation therapy or from jaw clenching or tooth grinding
  
  
• Mouth pain, which is caused by nerve damage from some types of chemotherapy
  
  
• Tissue and bone loss in the jaw, a possible long-term side effect of radiation therapy
  
  
• Physical changes to the mouth, jaw, or tongue, as a result of surgery

Management

Because chewing problems interfere with eating, it is important that you talk with your doctor about treatment options. The doctor may refer you to a speech therapist, a professional who specializes in helping people use the muscles in the mouth and throat. A speech therapist can teach a person how to chew more easily, especially if surgery has changed the structure of the mouth or tongue.

A dentist can evaluate tooth or gum pain or denture problems and provide treatment to help prevent future problems. A person may be prescribed special fluoride gels or mouth rinses to help prevent tooth decay or gum disease. Taking good care of your teeth and mouth with proper brushing and flossing will also help prevent dental problems.

The doctor or dentist may also prescribe medications to reduce inflammation and pain. Some pain medications can be used as a mouth rinse directly before eating. People with mouth infections, such as a fungal infection like thrush, may be given medication to treat the infection.

Chewing problems caused by jaw pain and stiffness can be treated with muscle relaxers, physical therapy (for example, massage, jaw exercises, moist heat), or in some cases, surgery.

Diet and eating tips for patients with difficulty chewing

Depending on the severity and cause of chewing problems, different suggestions may work better for some patients than for others. Try different types of foods with the goal of eating a nutritious diet that has enough calories, protein, and vitamins and minerals. Here are some more tips.

• Eat soft, smooth foods, such as yogurt, pudding, and ice cream.
  
  
• Mash or blend foods to make homemade shakes, or add blended vegetables or ground meats to casseroles or soups.
  
  
• Moisten dry foods with broth, sauces, butter, or milk.
  
  
• Take sips of water or other liquids while eating to keep the mouth and food moist.
  
  
• Try softer versions of your favorite fruits or vegetables, like applesauce or pureed carrots; switch to softer fruits and vegetables, such as bananas or peas; or consider eating baby food.
  
  
• Cut food into small bites and chew slowly and thoroughly.
  
  
• If you are losing weight, eat smaller, more frequent meals that are high in protein and calories, such as eggs, milkshakes, casseroles, and nutritional shakes.
  
  
• Avoid dry, coarse, or hard foods and foods that need a lot of chewing.
  
  
• Meet with a registered dietitian (RD) for additional help on eating a balanced diet.

More Information

Dental Health During Cancer Treatment

Taste Changes

Managing Side Effects

Last Updated: April 30, 2009