Heated Words: Burning Mouth Syndrome
Heated Words: Burning Mouth Syndrome
STORY BY Imelda Gott
Last Updated: 10-23-2003

Retired police officer James Maddox noticed a metallic taste in his mouth in 1999 after extensive dental work. Soon, the metallic taste vanished, but he was left with a constant burning. Since then, he has seen dentists, neurosurgeons, even the dean of a dental school—an oral pathologist—to find a way to put out the fire.

Three percent of the population endures Burning Mouth Syndrome (BMS), a condition that is poorly understood but is exacerbated by certain diseases like Sjogren’s (pronounced “SHOW-grins”) Syndrome and other medical problems.

BMS is a chronic condition that may last for years. Of those sufferers, 25 percent have a taste disorder. Fourteen percent of post-menopausal women experience BMS. And although estrogen deficiency may trigger the problem, (which doesn’t improve with replacement hormones) men are not immune.
Say ‘AHHHH’

Almost everyone has experienced unusual feelings in the mouth: dryness, rough areas, heat sensation or a metallic taste—maybe from stress, fever, spicy foods, upset stomach or medication. This may be uncomfortable, but it usually goes away about the time you make a dental appointment for it. BMS does not disappear so quietly or quickly.

Dry mouth itself brings a slew of customers to a dentist’s or doctor’s office. “More than 200 medications actually cause dry mouth. It also can be caused by diseases, in particular, Sjogren’s Syndrome,” explains Catherine M. Flaitz, D.D.S, M.S., interim dean of the University of Texas Dental Branch at Houston.

Sjogren’s is an autoimmune disorder, in which white blood cells attack the moisture-producing glands. Signature symptoms are dry eyes and dry mouth, but it is a systemic disease that can affect multiple organs. Up to 4 million Americans have Sjogren’s. Often, but not always, says Flaitz, Sjogren’s is the trigger for BMS.

BMS

“ I have had patients in their 30s and 40s who have had it. Usually, it coincides with a recent severe cold or flu. The initiating factors seem to be different in the accelerating age groups. It can be associated with systemic diseases,” Flaitz points out. Low-functioning thyroid, diabetes, some forms of anemia, nutritional problems, autoimmune diseases, and yeast infection in the mouth can also play a part.

“Also, it can be associated with Parkinson’s and stomach problems, such as reflux disease and chronic irritation from the ”she adds.
Why the Scalding Pain?

“My patients compare it to the feeling of scalding coffee in the mouth.” Flaitz says that the most confounding aspect of BMS is that it can continue indefinitely. Although it is not a serious problem in itself, it certainly can interfere with the quality of life.

Flaitz suggests that people who are experiencing this problem seek help first from a dentist to check out the obvious culprits. “Ordinarily, a healthcare professional would be able to look in your mouth and see that something isn’t right. There might be some shaggy white patches, or a little bit of redness,” Flaitz observes. BMS is the result of nerve damage that changes one’s perception of taste, temperature, touch and moisture, but it can’t be visually identified.

Local causes might include:

* allergies to toothpaste or mouth rinse
* yeast infection
* chewing gum, primarily cinnamon flavor
* habits of rubbing jagged teeth against sensitive areas.

Putting Out the Fire

If BMS is not due to one of the local factors, Flaitz believes in the simple approach:

* brush with bland, non-foaming toothpaste that is formulated specifically for dry mouth conditions
* chew sugarless gum that will not promote tooth decay. It serves as a distraction and stimulates the nerves that produce saliva
* take a multiple vitamin taken daily
* sip on cold water or suck on crushed ice to help restore moisture and numb the mouth
* do regular exercise for overall improved health and well being
* keep a diary and avoid foods/ beverages that trigger the sensation.

She mentions that simply the flavor of gum may be helpful to some patients, while others find the taste only increases bitterness. If these tactics fail, then antidepressant medications at low doses may be helpful to reduce the anxiety or preoccupation of the sensation. It usually takes a couple of months before these medications become effective.
It’s Not Cancer

Many people with BMS fear they have cancer. “Because they’ve heard that if you’re in constant pain that doesn’t go away, that’s a sign of serous illness, like cancer.”

Flaitz explains why BMS feels different: “With cancer, you don’t have pain in the entire mouth, as you do with BMS. You can have cancer metastasize and move to the mouth. The tumor cells can wrap around nerves in the beginning causing a more severe type of pain that is localized to one side. Then the mouth gets numb.”

Maddox reports that about a week ago for one day, the burning completely disappeared for the first time in more than four years. He thought he was over BMS. It returned the next day. His neurologist told him BMS showed up one day without warning, and it might just go away the same way. He says he hopes she’s right.

For more information: http://www.sjogrens.org/
©2000-2009 Office of Institutional Advancement, UT-Houston
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