What is chronic GVHD of the mouth (oral GVHD)?

Chronic graft-versus-host disease (GVHD) of the mouth happens when donated cells a patient receives during a blood or marrow transplant (BMT) begin attacking the saliva (spit) glands and soft tissues in the mouth.

Saliva keeps your mouth moist, protects your teeth and helps you swallow. When GVHD damages the saliva glands or other mouth tissues, it can lead to mouth dryness, pain and changes in how your mouth feels or functions.

• Dry mouth that doesn’t improve with fluids
• Redness, white patches or open mouth sores
• Pain or burning, especially when eating
• Chapped or sore lips
• Swollen or painful tongue
• Changes in taste or sensitivity to spicy, acidic or fizzy foods
• Mucoceles (painless bumps inside the mouth)
• Trouble opening your mouth wide

• Difficulty swallowing due to dryness in the mouth or throat
• Increased risk of cavities from low saliva production

To learn more about how GVHD can affect different parts of your body, view our full list of GVHD symptoms.

There are steps you can take each day to ease symptoms and protect your oral health. Talk to your care team before starting new products or treatments.

• Sip water throughout the day to keep your mouth moist.
• Chew sugar-free gum or suck on sugar-free candy to help stimulate saliva.
• Take small bites and drink fluids while eating to make swallowing easier.
• Brush twice daily with a soft toothbrush. Use gentle or children’s toothpaste if others irritate your mouth.
• Floss once a day and schedule regular cleanings with your dentist.
• Avoid coffee and alcohol.
• Ask your dentist about fluoride treatments to help prevent cavities.

• Check for new white patches, sores or bumps.
• Let your doctor know if you notice more pain or dryness.
• Report trouble eating, swallowing, opening your mouth or developing a sore throat after transplant.
• Tell your care team if you develop new sensitivity to foods or drinks.

• Your mouth becomes more dry.
• You have pain or swelling in your mouth or throat.
• You have trouble opening your mouth wide.
• You notice new bumps, color changes or sores that don’t heal.

Your doctor or dentist can usually diagnose oral GVHD during a visual exam. In some cases, they may test for infections or other conditions that look similar.

If oral GVHD is confirmed, treatment may include:

• Prescription steroid rinses or gels to reduce pain and inflammation.
• Topical anesthetics or pain medications before meals.
• Prescription medicines like cevimeline or pilocarpine to help your body make more saliva.
• Reviewing your current medications to see if any may be causing dry mouth.

NMDPSM offers resources to help you navigate GVHD of the mouth and connect with people who understand your journey. Choose the support that’s right for you: