Burning Mouth Syndrome

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Burning Mouth Syndrome
Authored By: Allison DiMatteo

Burning mouth syndrome (BMS) is a chronic, painful condition characterized by burning sensations in the tongue, lips, palate (roof of the mouth), gums, inside of the cheeks and the back of the mouth or throat. The discomfort cannot be easily attributed to any physical abnormalities in the mouth or any underlying medical disorders. A complicated and poorly understood condition, burning mouth syndrome affects seven times more women than men. Most people suffering from burning mouth syndrome are middle aged, but younger individuals also have been affected by the condition.

Burning mouth syndrome may also be called burning tongue syndrome, burning lips syndrome, glossodynia, stomatodynia and scalded mouth syndrome.
Symptoms of Burning Mouth Syndrome

There are a number of symptoms associated with burning mouth syndrome, most notably the sensation of pain or burning. The pain or burning sensation is typically mild in the mornings, becoming progressively more intense throughout the day, peaking in the evening and subsiding at night. Some burning mouth sufferers feel continuous pain while others experience intermittent burning sensations. The pain associated with burning mouth syndrome can last for several months or years.

Other symptoms of burning mouth syndrome include a sore or dry mouth, tingling or numbness on the tip of the tongue or in the mouth and bitter or metallic changes in taste.
Causes of Burning Mouth Syndrome

Multiple systemic, oral and psychological factors have been associated with burning mouth syndrome. The exact cause of the condition is still not clearly understood. Psychological factors (such as anxiety or depression) may be a cause and effect of the frustrating burning sensations, with each aggravating the other. Sodium lauryl sulfate, a surfactant used in many types of toothpaste, has also been implicated as a possible cause of burning mouth syndrome.

It is important to note that a diagnosis of burning mouth syndrome is made in the absence of other oral or systemic conditions that could cause the burning sensations. Because a burning sensation in the mouth can result from, or be a symptom of, a number of medical conditions, several oral and systemic diseases must be ruled out before a diagnosis of “burning mouth syndrome” can be made.

If you are experiencing burning sensations in your mouth, it is important that you visit your dentist as soon as possible to discuss your symptoms and undergo an examination. Your dentist will likely review your complete medical history and perform a thorough oral examination in order to help identify the cause of the burning sensations in your mouth. If oral thrush (oral candidiasis), Sjogren’s syndrome and/or other dental issues are ruled out as the cause, you may be referred to a physician or specialist (oral pathologist) to treat the condition. Blood work and other diagnostic tests could include those that look for infection, nutritional deficiencies, diabetes or thyroid problems and allergy testing.
Factors Affecting Burning Mouth Syndrome

There are various factors that can cause burning mouth syndrome, some of which include:

Nutrition: Deficiencies of iron, folate and vitamin B complex have been associated with a burning sensation in the mouth. As a result, some treatment approaches have included supplements of B vitamins and minerals like zinc and iron.

Dry Mouth (xerostomia): Medications, Sjogren’s syndrome, and any number of other causes can lead to dry mouth and its related burning sensation. Drinking more liquids, using artificial saliva and/or eliminating the cause of the dry mouth may eliminate the burning sensation.

Oral Candidiasis (Oral Thrush): A symptom of this oral fungal infection is a burning sensation in the mouth, particularly when consuming acidic or spicy foods, or when the cottage-cheese like lesions are scraped from the inside of the mouth. The plan that your dentist recommends to treat oral thrush can help end the burning sensations associated with this oral yeast infection.

Anxiety/Depression: Psychological causes for burning mouth syndrome are considered when no other reason or explanation for the burning sensation can be found. Stress from depression and anxiety can alter the flow and composition of saliva, as well as initiate oral habits that compound problems that trigger burning mouth syndrome. These include tongue thrusting and teeth grinding (bruxing), both of which can irritate the mouth and lips.

Diabetes: Diabetics are more susceptible to oral infections (including oral thrush) that produce burning mouth sensations. Additionally, diabetics are prone to vascular changes that affect the small blood vessels in the mouth, creating a lower threshold for pain. Therefore, it is important for diabetics to maintain control of their blood sugar levels in order to help resolve the burning mouth symptoms.

Menopause: Hormonal changes have been associated with a burning sensation in the mouth in middle-aged women. Burning mouth is among the most common oral manifestations of menopause. However, hormone replacement therapy has only been effective in relieving burning mouth symptoms in certain patients.

Other: Nerve damage (neuropathy) affecting taste and pain in the tongue and dysfunction of the nerves in this area has been thought to be responsible for burning mouth. Additional causes of burning mouth syndrome could be irritating dentures (denture stomatisis), allergies, gastroesophageal reflux disease, thyroid problems, tongue thrusting and cancer therapy.
Treatment for Burning Mouth Syndrome

The treatment for burning mouth syndrome aims to alleviate symptoms. Burning mouth syndrome treatments include different medications traditionally used to relieve the underlying causes of other conditions, such as depression and chronic pain. Tricyclic antidepressants (amitriptyline/Elavil), antipsychotics (chlordiazepoxide/Librium), anticonvulsants (gabapentin/Neurontin), analgesics, benzodiazepines (clonazepam/Klonopin) and mucosal protectors have provided effective relief for some patients. In addition, topical capsaicin (the natural chemical in cayenne pepper) has been used to desensitize patients suffering from burning mouth syndrome.

However, despite the success of these approaches in certain situations, there is no universal treatment for burning mouth syndrome that is effective in all cases. Treatment is planned to meet the specific needs of each patient. The cost of treatment varies depending upon the medications prescribed (if any), how long they will be needed and whether or not medical and/or dental insurance will cover all or some of the costs.

Additional relief from the symptoms of burning mouth syndrome may be achieved by making some simple changes:

* Stop using mouthwash that contains alcohol.
* Stop using toothpaste that contains sodium lauryl sulfate.
* Chew sugarless gum, preferably sweetened with xylitol.
* Avoid alcoholic beverages.
* Use baking soda and water when brushing your teeth.
* Refrain from drinking beverages with high acidity (fruit juices, coffee, soft drinks).
* Abstain from tobacco use.
* Sip water or suck on ice chips.

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