Burning Mouth Syndrome
What Is It?
Burning Mouth Syndrome is a common yet complex problem that causes the individual to experience a burning or scalding pain on the lips, tongue and sometimes throughout the mouth. There are often no visible signs of irritation. The cause of the syndrome may be caused by the onset of menopause to vitamin deficiencies. About 5% of the population, usually people over the age of 60 are affected with this condition. It often occurs more frequently in older women, often in menopausal women.
- A side effect of medication — Dry mouth is a potential side effect of hundreds of nonprescription and prescription drugs, including pain relievers, decongestants, antidepressants and antihistamines. Medications are the most common cause of xerostomia. Because of the number and types of medications that many older people take, xerostomia has an especially high rate of occurrence among the elderly.
- A complication of diseases and infections — Diseases such as diabetes, anemia, cystic fibrosis, rheumatoid arthritis, hypertension and HIV infection can be associated with dry mouth. Xerostomia also occurs with Sjogren’s syndrome, an autoimmune disease in which the body’s antibodies attack the salivary and lacrimal (tear) glands. Some viral infections, such as mumps, also affect saliva production and result in xerostomia.
- Dehydration — Any condition that leads to dehydration can also cause xerostomia. These conditions include fever, excessive sweating, vomiting, diarrhea, blood loss or loss of water through the skin resulting from burns.
- Radiation therapy — Xerostomia is a common side effect of radiation therapy to treat cancers in the head and neck.
- Surgical removal of the salivary glands
Although xerostomia is a symptom in itself, it may occur with other associated symptoms, including:
- burning sensation in mouth, throat, lips and tongue
- scalding feeling
- dry mouth,
- bitter or metallic taste
- taste alterations
- changes in eating habits
- changes in medications
- pain which can be gradual and spontaneous, intensifying as the day goes on
- interferes with sleep
- restlessness that may cause mood changes, irritability, anxiety and depression
- Conditions associated with this condition:
- onset of menopause-hormonal changes
- deficiencies in iron, zinc, folate, thiamin, riboflavin, pyridoxine, cobalamin, vitamin B-12, niacin, iron
complications to cancer therapy
- 1/3 of people say BMS symptoms appear shortly after dental procedure, recent illness, or medication course.
- 70% of cases have no specific diagnosis for symptoms and doctors are unable to pinpoint the source, it may occur from:
- dry mouth, tongue thrusting
- irritating or ill fitting dentures
- thrush or fungal infections- a yeast infection of the mouth, a course of Mycelex/Nystatin may help
- nerve disorders or damage
- psychological factors. depression, anxiety
- acid reflux
- dietary deficiency….can be seen in vegetarians
- Sensitivity to the material of the denture
- Dental trauma
- Medications, such as diuretics, oral diabetes medications, and some blood pressure medications, as well as various over-the-counter medicines, can cause symptoms of glossodynia.
Medical history is taken. Oral causes for BMS will be determined by taking an oral swab or biopsy to check for thrush. Dry mouth examination along with seeing general physician or specialist for other blood, allergy, liver or thyroid tests.
Possible Treatments: Will vary depending on the cause. For the 70% of people where no diagnosis can be pinpointed, your dentist will treat the symptoms through:
- Antifungal therapy
- Vitamin and mineral replacements
- Creams or lozenges containing capsaicin …..low doses of capsaicin (a red pepper derivative that works by overwhelming the mouth by providing the pain with a distraction.).
- Hormonal replacement
- Antidepressants (to mask the burning sensation that occurs on the tongue by changing the brain chemicals)
- Mental health counseling
- Intraoral appliances
- Topical rinses
Thioctic acid may be a treatment for burning mouth syndrome:
Burning mouth syndrome (BMS): double blind controlled study of alpha-lipoic acid (thioctic acid) therapy.
Burning mouth syndrome (BMS) has features of a neuropathy and could be related to the production of the toxic free radicals that are released in stress situations. Alpha-lipoic acid is an antioxidant able to increase the levels of intracellular glutathione and eliminate free radicals. This study aimed to examine the effectiveness of alpha-lipoic acid in the therapy of BMS. METHOD: This was a double blind, controlled study conducted for two months on 60 patients with constant BMS. Comparing alpha-lipoic acid (test) with cellulose starch (placebo), there was no laboratory evidence of deficiencies in iron, vitamins or thyroid function and no hyperglycaemia. RESULTS AND CONCLUSION: Following treatment with alpha-lipoic acid, there was a significant symptomatic improvement, compared with placebo, with the majority showing at least some improvement after 2 months, thus supporting the hypothesis that burning mouth syndrome is a neuropathy. This improvement was maintained in over 70% of patients at the 1 year follow-up.