Burning Mouth Syndrome

If you think you have burned your tongue but it doesn’t seem to be getting any better, you may be suffering from burning mouth syndrome (BMS). Generally speaking, a burned tongue will recover in two weeks or less. However, if the symptoms continue for longer than that, it may be a good idea to check with an ear, nose and throat specialist to see if you are suffering from BMS.

What is burning mouth syndrome?
Burning mouth syndrome1 is described as a “burning, scalding, or tingling feeling in the mouth that may occur every day for months or longer.” It may also be accompanied by dry mouth. BMS occurs most commonly after the age of 60 and women are five times more apt to suffer from it than men. Other symptoms of the syndrome can include:

  • Numbness in the mouth that comes and goes
  • Pain in the tongue
  • Pain on the roof of the mouth, or throughout the mouth
  • Pain in the lips
  • A lingering metallic taste in the mouth
  • Altered sense of taste

The amount of pain caused by BMS and its frequency differs for each person. For some, the pain comes and goes while, for others, it is more constant and increases in intensity throughout the day. The pain can last for months or years.

There are different causes of burning mouth syndrome
There are two different types of burning mouth syndrome. Each is diagnosed based on the causes of the condition.

Primary burning mouth syndrome is caused by damage to the nerves in the mouth and/or tongue that control pain and taste.

Secondary burning mouth syndrome is caused by medical conditions that can include:

  • Hormonal changes, including those caused by diseases or from a thyroid imbalance
  • Allergies to food
  • Allergies to materials used in dental products like metal
  • Certain drugs like high blood pressure medications
  • Radiation therapy
  • Infections in the mouth
  • Acid reflux
  • Poorly fitting dentures
  • Dry mouth
  • Deficiencies in diet including low levels of vitamin B or iron

How is burning mouth syndrome diagnosed?
Diagnosing BMS can be challenging because there is no specific clinical test for it. There is nothing for a doctor or dentist to see in the mouth that would indicate the presence of the syndrome. In fact, BMS is usually diagnosed only when all other causes of mouth pain are ruled out. In an effort to eliminate underlying causes, the doctor may run the following tests:

  • Blood tests
  • Oral swab tests
  • Allergy tests
  • Salivary flow test
  • Biopsy of tissue in the mouth
  • Imaging tests
  • Gastric reflux tests
  • Temporarily stopping medications to determine if they are the cause

Treatments for burning mouth syndrome
Once a doctor believes that the cause of the symptoms is burning mouth syndrome, a variety of treatments may be recommended. No one treatment works for everyone so trial and error may be required to find the one that is most effective.

Physicians may first recommend lifestyle changes that may reduce the symptoms including:

  • Changing medications if one is thought to be causing the symptoms
  • Drinking cold liquids
  • Chewing sugarless gum
  • Chewing on ice chips
  • Avoiding food and drink that may irritate tissues in the mouth and on the tongue, i.e.,
    • Spicy foods
    • Highly acidic fruit juices and fruits
    • Mouthwashes that contain alcohol
    • Alcoholic drinks
    • Tobacco products

Additional clinical treatments that may be recommended:

  • Oral rinses
  • Lidocaine that can numb the surface of the mouth
  • Products to replace saliva
  • Pain relievers such as Capsaicin
  • Medications including clonazepam (Klonopin), anti-depressants or those that block nerve pain

Burning mouth syndrome is uncomfortable, to say the least, and can preoccupy one’s days with pain and discomfort. Seeking care from an ear, nose, throat specialist may lead to diagnosis and can lead to treatments that may ease the pain and discomfort.

 

 

References
1: https://www.nidcr.nih.gov/health-info/burning-mouth


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