Burning Mouth Syndrome - Academy of General Dentistry

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Burning Mouth Syndrome -
What is Burning Mouth Syndrome?
Burning Mouth Syndrome (BMS) is a common, but complex problem that causes patients to experience a burning or scalding pain on the lips and tongue (and sometimes throughout the mouth). There are often no visible signs of irritation, and the cause of the syndrome may be caused by the onset of menopause to vitamin deficiencies. According to research from the Mayo Clinic, BMS may affect up to 5 percent of the U.S. population and people usually over age 60. Though members of both sexes are susceptible to BMS, it occurs more frequently in older women (research says that between 10 percent and 40 percent of postmenopausal women report symptoms of BMS). The syndrome is also called glossodynia (tongue pain) and stomatodynia (mouth pain). BMS is not a form of nor can cause cancer.
What are common symptoms of BMS?
There are a variety of symptoms associated with BMS. The main symptom is a burning sensation, ranging from moderate to severe, in your mouth, throat, lips and tongue. Many patients have described the feeling as ǃ?scalding.ǃ? Other symptoms include dry mouth, bitter or metallic tastes and other taste alterations. Patients with BMS often say that the pain is gradual and spontaneous, intensifying as the day moves along. It can affect a personǃÙs ability to fall asleep. The discomfort and restlessness associated with BMS may cause mood changes, irritability, anxiety and depression.
What causes BMS?
The exact cause of BMS is difficult to determine. In 30 percent of cases it is caused by a variety of existing conditions that affect the oral and systemic health. Some conditions include the onset of menopause, diabetes, and deficiencies in such nutrients as iron, zinc, folate, thiamin, riboflavin, pyridoxine and cobalamin, and complications to cancer therapy (radiation and chemotherapy) .
In 70 percent of cases, no specific diagnosis for the symptoms can be made. BMS symptoms may occur from xerostomia (dry mouth), tongue thrusting, bruxism (teeth grinding), irritating or ill-fitting dentures, and thrush (a common fungal infection characterized by a white discharge). Some research points to nerve disorders and damage; psychological factors, particularly depression and anxiety; allergies; acid reflux; and medications that cause dry mouth. ItǃÙs not unusual for a patient suffering from BMS to have more than one cause attributed to the ailment or to have health care providers fail to find any cause at all.
According to research from the American Academy of Family Physicians, about one-third of patients say BMS symptoms appeared shortly after a dental procedure, recent illness or medication course.
How is BMS diagnosed?
Since BMS is difficult to diagnose because the cause could stem from any number of conditions, both physical and psychological. For this reason itǃÙs important to consult with your dentist and physician to develop an appropriate treatment plan. Your dentist will begin by reviewing your medical history and asking you to describe the symptoms. He or she may look for oral causes by taking an oral swab or biopsy to check for thrush. He or she may also look for signs of dry mouth. But because BMS is caused by so many conditions, your dentist may refer you to a general physician or specialist for other blood, allergy, liver or thyroid tests.
How will my dentist treat my BMS?
Treatment for BMS depends on the patient and the cause. If the cause is related to the oral cavity, your dentist has a variety of ways to provide relief. For dry mouth, your dentist may advise that you drink more fluids, or he or she may prescribe medicine that promote the flow of saliva. Thrush may be treated with oral anti-fungal medications, such as nystatin (Mycostatin, Nilstat) or fluconazole (Diflucan). If dentures are the culprit, your dentist can make adjustments so they wonǃÙt irritate the mouth, or replace them with better fitting dentures.
What if my dentist canǃÙt treat my BMS?
If your dentist determines that there are no oral conditions causing BMS, he or she may refer you to your family physician or a specialist. The physician will most likely start with a complete blood count to determine the best course of treatment. If menopause is to blame, then hormone replacement therapy may be recommended. They may also recommend other medicines or treatments to provide relief. If the results of the test are inconclusive, the doctor may be able to treat the symptoms with medicine.
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The Academy of General Dentistry is a non-profit organization of more than 37,000 general dentists dedicated to staying up-to-date in the profession through continuing education. A general dentist is the primary care provider for patients of all ages and is responsible for the diagnosis, treatment, management and overall coordination of services related to patient's oral health needs. Learn more about AGD member dentists or find more information on dental health topics at www.agd.org/consumer.
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