Burning mouth can be a sign of stress or disease

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Burning mouth can be a sign of stress or disease
July 12, 2005
DR
ALLEN DOUMA
Newsday.com: THE FAMILY DOCTOR
I have a burning, stinging mouth that includes the tongue, lips and gums. I've sought help, but I get blank stares and no answers. It's so bad that I can't use tooth paste at all, but even food affects it. What kind of doctor treats burning mouth?
E.H., Smithtown
Although little is known about the condition, some research is being done to learn more about the causes and treatments of burning mouth syndrome. The painful burning sensation most commonly occurs in the front of the tongue. Other complaints include dryness and taste alterations.
Various local, systemic (bodywide) and psychological factors have been linked with it, but a single cause - or even multiple causes - has not been found.
Some researchers suggest that the syndrome is more of a "marker" of illness or stress than a disease in itself.
Conditions reported in association with burning mouth syndrome include: chronic anxiety, depression, various nutritional deficiencies, Type 2 diabetes and changes in saliva glands. However, these conditions have not been consistently linked with the syndrome, and their treatment often is not associated with any change in the symptoms.
Some studies have found that 10 percent of people using tartar-control toothpastes will develop a burning sensation. Since you have stopped using all toothpaste, this is probably not the cause in your case.
Other recent studies have pointed to dysfunction of several cranial nerves (nerves in the head) associated with taste sensation as a possible cause of burning mouth syndrome.
This distressing situation regarding the lack of knowledge about the cause is also true with respect to treatment. Most treatments tried for burning mouth syndrome have had limited success.
Benzodiazepine anti-anxiety drugs, tricyclic antidepressants, or anticonvulsants are effective in some people with burning mouth syndrome. Topical capsaicin (the ingredient in peppers that makes them hot) has been helpful for some. Because there is so little understanding of the cause of this problem - and there are probably many causes - it's even more important to try to remember changes in your life, including dietary changes, that occurred shortly before the symptoms started. Although most people with this problem are treated by nonspecialists, you may want to consider getting advice from an ear, nose and throat specialist or a dentist.
ALLEN DOUMA spent 12 years in clinical practice. He has written, edited and advised on numerous medical publications. Send questions to The Family Doctor, Newsday, 235 Pinelawn Rd., Melville, NY 11747-4250. Questions cannot be answered personally.