Burning Mouth Syndrome

February 7, 2017

Burning mouth syndrome (BMS) is a chronic, painful condition characterized by burning sensations in the tongue, lips, palate (roof of the mouth), gums, inside of the cheeks and the back of the mouth or throat. The discomfort cannot be easily attributed to any physical abnormalities in the mouth or any underlying medical disorders.

BMS is exactly as it sounds, i.e. a burning or tingling sensation inside the mouth that affects the tongue, roof, gums, cheeks and even the throat. Accompanied by other symptoms such as dry mouth, soreness, a tingling or numb feeling, or a bitter or metallic taste, burning mouth syndrome can cause extreme discomfort to those affected by it. BMS can affect any part of the mouth, including the lips, but it occurs most often on the tongue, along with various other areas.

The syndrome isn’t deadly – it’s at worst painful and extremely annoying—but it is mysterious. It occurs when nerve fibers in the mouth begin functioning abnormally, sending pain signals to the brain without external stimulus. It’s like as if the mouth constantly thinks the person is drinking an incredibly hot cup of coffee and is desperately trying to tell to cut it out. Perhaps the strangest thing about the disorder is that, for many sufferers, it stops when they fall asleep. Patients have reported a brief respite from symptoms when they wake up in the morning, though the pain starts to come back over the course of the day.

Who is at Risk?

Burning mouth syndrome is seen predominantly, but not exclusively, in peri- and post-menopausal women. Males can be affected. The incidence increases with advancing age. It is rarely seen before the age of 30 years. No racial or ethnic differences have been reported. It probably affects approximately 1% of the general population, rising as high as 30% in selected populations such as post-menopausal women.

Burning mouth syndrome may be associated with personality or mood disturbances, particularly anxiety and depression. It is not clear if these are due to the mouth symptoms or if they contribute to the development of the problem. Tooth grinding, tongue thrusting and jaw clenching are also commonly associated and may only be identified by asking family members.

Causes

Causes of burning mouth syndrome are complex and although it is not entirely known, it is linked to many other factors. Possible causes or triggers include –

Oral Problems – There are several mouth conditions that contribute to burning mouth syndrome. Dry mouth, oral thrush and Sjogren’s syndrome, a disease that causes dryness, are all suspects in causing a flare-up.

Menopause and Hormonal Imbalances – Menopausal women go through many hormonal changes, which can affect the amount of saliva produced in your mouth. For anyone who experiences a hormonal imbalance, burning mouth syndrome is often an aggravating side effect.

Medical Conditions – Burning or scalding sensations may result from diabetes or thyroid problems, acid reflux (when acid from the stomach comes up into the mouth), thrush (a fungal infection in the mouth, also called ‘candida’) etc.

Vitamin Deficiencies – Nutrition is a key factor in preventing burning mouth syndrome. Nutritional deficiencies that result from a lack of iron, zinc and B vitamins, among others, can increase your chances of experiencing dry or burning mouth.

Acid Reflux Disease – Stomach acid can irritate your oral tissues, leading to several dental problems.

Medications and Medical Treatments – High blood pressure medications and antidepressants are just two of the several drugs that promote burning mouth. Your pharmacist can help you determine if the medications you’re taking cause dry mouth. Burning mouth syndrome has also been linked to radiation and chemotherapy treatments for cancer patients.

Mouth Irritations – There are so many irritants that can affect your dental health. Not surprisingly, acidic drinks, smoking and some mouthwashes are drying agents that contribute to the burning sensations. But other irritants play a role as well – Loose fitting dentures, bruxism, tongue thrusting and hard tooth brushing will also aggravate your oral tissues.

Allergies – Burning mouth may be an allergic reaction to foods or other elements in some patients.

Nerve Damage – Damaged nerves in the mouth and on the tongue affect more than just your taste buds. Your nerves control pain, and burning mouth syndrome may be a sign of nerve damage

The Psychological Aspect – Perhaps the most intriguing of all the elements that contribute to burning mouth syndrome, emotional problems, such as anxiety or depression, also enable the condition. On the other hand, the discomfort and frustration felt by the patient can also affect his or her mental health.

Symptoms

The main symptom of burning mouth syndrome is a burning sensation involving your tongue, lips, gums, palate, throat or widespread areas of your whole mouth. People with the syndrome may describe the sensation in the affected areas as hot or scalded, as if they had been burned with a hot liquid.

Other symptoms may include –

Dry mouth
Sore mouth
A tingling or numb sensation in your mouth or on the tip of your tongue
A bitter or metallic taste

Some people with burning mouth syndrome don’t wake up with mouth pain, but find that the pain intensifies during the day and into the evening. Some have constant daily pain, while others feel pain on and off throughout the day and may even have periods in which they feel no pain at all.

Burning mouth syndrome affects women seven times as often as men. It generally occurs in middle-aged or older adults. But it may occur in younger people as well.

Complications

Complications that burning mouth syndrome may cause or be associated with are mainly related to discomfort. They include –

Difficulty falling asleep
Depression
Anxiety
Difficulty eating
Decreased socializing
Impaired relationships

Treatment

Medications – Medicines are not often used for burning mouth syndrome, as there is not enough research to know whether they help. They can also cause side effects. Below we list some medicines that have been studied.

Antidepressants are usually used to treat depression, but some types can also help with nerve pain. However, there’s not enough research to know whether they work for burning mouth syndrome. Antidepressants can cause side effects, including drowsiness, a dry mouth, shaking, constipation, and stomach upsets.
Burning mouth syndrome is more common in women who have reached the menopause. So doctors have looked at whether hormone replacement therapy (HRT) might help. But there hasn’t been enough research to be sure.
Clonazepam (brand name Rivotril) is usually used to treat epilepsy. Some research suggests that sucking a clonazepam tablet might reduce the pain in people with burning mouth syndrome. But clonazepam can have serious side effects, including drowsiness, dizziness, poor concentration, and confusion. It can also be addictive.

Cognitive behavior therapy (CBT) is a talking treatment (psychotherapy) sometimes used for burning mouth syndrome. It might seem odd to have a talking treatment for the physical symptoms. But research shows CBT can help to cope better with pain. It may reduce the burning feeling, or make it go away altogether.

Self Help – Additional relief from the symptoms of burning mouth syndrome may be achieved by making some simple changes –

Stop using mouthwash that contains alcohol.
Stop using toothpaste that contains sodium lauryl sulfate.
Chew sugarless gum, preferably sweetened with xylitol.
Avoid alcoholic beverages.
Use baking soda and water when brushing your teeth.
Refrain from drinking beverages with high acidity (fruit juices, coffee, soft drinks).
Abstain from tobacco use
Suck on ice chips

Alternative Treatment

Vitamin B – The burning mouth syndrome is often a result of vitamin deficiency. One of the most commonly deficient nutrients associated with the condition is vitamin B, so boosting the intake of the nutrient is an effective way to treat the condition.

Alpha-Liopic Acid – Studies suggest that alpha-lipoic acid (ALA) as an effective remedy for burning mouth syndrome. This nutrient is a powerful antioxidant that helps protect your body against free radicals. It also helps recover the function of the nerve cells and prevent further damage.

Zinc deficiency may be a cause of burning mouth syndrome as zinc replacement therapy has therapeutic effects. Zinc is a mineral known to play an important role for growth and development, the immune response, neurological function, and reproduction. Although the etiology of burning mouth syndrome (BMS) is unknown, zinc deficiency may be implicated in the pathogenesis of BMS. Zinc deficiency might play a role in some patients with BMS.

Glycerin – Applying glycerin over the tongue can reduce the burning sensation as well.

Triphala And Babool Decoctions – Gargling with a decoction prepared of the ayurvedic herb, triphala, is a good home remedy for burning tongue. This is said to be cooling for the tongue.

Lavender is another effective remedy for BMS. This treatment helps soothe pain and reduce inflammation.

Reference –

http://familydoctor.org/familydoctor/en/diseases-conditions/burning-mouth-syndrome.html

http://www.msdmanuals.com/home/mouth-and-dental-disorders/lip-and-tongue-disorders/burning-mouth-syndrome

http://www.aaomp.org/public/burning-mouth.php

http://www.colgateprofessional.com/patient-education/articles/burning-mouth-syndrome

http://www.aafp.org/afp/2002/0215/p615.html

http://www.livescience.com/50455-burning-mouth-syndrome-herpes.html

http://rarediseases.org/rare-diseases/burning-mouth-syndrome/

http://www.mayoclinic.org/diseases-conditions/burning-mouth-syndrome/basics/definition/con-20029596

http://www.webmd.com/oral-health/burning-mouth-syndrome

http://emedicine.medscape.com/article/1508869-overview