Stinging discomfort is likely burning mouth syndrome

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Stinging discomfort is likely burning mouth syndrome
13 January 2008
Mayo Clinic

DEAR MAYO CLINIC:

My sister has had a condition which causes her tongue and mouth to constantly sting and burn, and most food tastes bitter to her. She has suffered for years because local doctors have not been able to diagnose or treat it. Can you explain what it might be?

ANSWER:
It sounds like your sister has burning mouth syndrome. This condition causes a burning sensation or soreness on a person's tongue or lips, or throughout the mouth, typically without any noticeable inflammation or irritation. These symptoms are often accompanied by a bitter or metallic taste. Burning mouth syndrome affects women seven times as often as men. It generally occurs in middle-aged or older adults. But it may occur in younger people as well.

Many factors can cause burning mouth syndrome. It's been linked to several medical conditions, including hormonal changes, gastric acid reflux, diabetes, hypothyroidism, pernicious anemia with inability to absorb vitamin B12, and dry mouth (xerostomia) due to Sjàgren's syndrome or from any cause. A diet that doesn't contain enough iron, zinc or certain B vitamins can lead to the condition. In addition, allergies, oral infections such as thrush and local irritation (like teethgrinding or dentures that don't fit properly) can be responsible. Certain medications can cause side effects that contribute to burning mouth syndrome, for example, angiotensin-converting enzyme (ACE) inhibitors, which are used to treat high blood pressure, and medications that cause a dry mouth.
Treatment depends on the cause. If an underlying medical condition is the source of the problem, treating that condition may improve burning mouth symptoms. For example, many people who have burning mouth syndrome also suffer from dry mouth. Often, when dry mouth is effectively treated - usually with saliva substitutes or prescription medications, along with self-care techniques - the burning mouth symptoms also subside.
If burning mouth is a side effect of a medication, changing to a different medication may help. Taking vitamin and mineral supplements can relieve the condition if a dietary deficiency is the cause. In some cases, adjusting or replacing ill-fitting dentures may be all that's needed.
Burning mouth syndrome is often linked to, or may be a sign of, underlying anxiety or depression. In this situation, your doctor may suggest that you see a psychiatrist. Antidepressants can be beneficial for managing chronic pain. In some cases, burning mouth syndrome is thought to be a form of neuropathy (a nerve disorder), and management strategies for chronic nerve pain may help. Acupuncture may also be an option, in some cases, for relieving symptoms if other therapies have not helped.

Your sister can take steps at home that can make a difference, too. Good oral hygiene, including gently brushing and flossing daily, can reduce the effects of burning mouth. Avoiding spicy or acidic foods, limiting alcohol, and not using tobacco may help. It's also important for people with the condition to have a dentist examine their teeth and mouth every six to 12 months to ensure oral health.
For a complete evaluation, your sister should see a physician who specializes in dermatology or oral medicine, for example. That specialist can assess her condition and develop a treatment plan for her situation. - Alison Bruce, M.D.,
Dermatology, Mayo Clinic, Rochester, Minn.