Glossodynia, commonly called burning of tongue or mouth, describes a sensation characterized by tongue pain, stinging or itching of the oral mucous membrane. Glossodynia may be triggered by a variety of factors and classified as either a primary or secondary condition, depending on its cause. Treatment is dependent on the presentation of the condition and the overall health of the individual.
Glossodynia is divided into two types: With or without observable alteration of the tongue.
The common observable signs are inflamed fungiform papillae or a slight, localized reddening due to trauma or atrophy of the filliform papillae and either localized or generalized lobulations and generalized redness. It may be associated with an altered taste.
Most often also, the women who experience this kind of condition are entering their menopausal stage or period. Persons with this kind of symptoms do not have organic lesion which are identifiable. Their reports of discomfort are associated with psychogenic basis. Also, there are no visible clinical changes noted with persons having this kind of symptom. It is considered to be the most common of the oral problems there is. In addition to that, this is considered as a psychosomatic kind of disorder.
Numerous causes of glossodynia have been suggested, including systemic factors such as nutritional deficiencies and climacteric; local factors such as candidasis (oral thrush) and denture trauma; xerosotomia (dry mouth); and psychogenic factors and sensory neuropathies.
Causes
Glossodynia then is normally considered a ‘psychosomatic’ condition suggesting that it is caused by the patients’ psychology. It’s ‘all in the mind’ as it were with no physical cause currently known. This does not mean that it is not a legitimate complaint, and many serious conditions are linked to our thoughts such as panic attacks and depression. In some cases even more physical problems such as IBS can be linked to our psychology.
Of course there is still some kind of ’cause’ that triggers glossodynia in certain individuals. These could be chronic anxiety or depression, menopause etc. The connection between the mind and the production of saliva can be demonstrated in many ‘every day’ situations such as the way in which we often feel we have a dry mouth as a result of nerves before giving a speech or when speaking to someone we are trying to impress.
Local Causes
- Candidiasis climacteric postmenopausal anxiety
- Migratory glossitits (geographic tongue) diabetes depression
- Lichen planus Sjogren’s Syndrome (xerostomia) cancerphobia
- Trauma drug reactions (xerostomia)
- Oral cancer deficiency states
- Denture faults anemias (Iron, B12, Folic Acid)
- Impression surface lingual artery atherosclerosis
- Polished surface fheumatoid arthritis
- Occlusal surface gastric disturbances, hyperacidity
- Denture plaque xerostomia
- Residual monomer hypothyroidism
- Sensitivity to dental materials
- Radiation therapy (xerostomia)
- Periodontal diseases
- Electrogalvanic discharge
- Climacteric postmenopausal
- Diabetes
- Sjogren’s Syndrome (xerostomia)
- Drug reactions (xerostomia)
- Deficiency states
- Anemias (Iron, B12, Folic Acid)
- Lingual artery atherosclerosis
- Rheumatoid arthritis
- Gastric disturbances, hyperacidity
- Xerostomia
- Hypothroidism
Psychological Causes
- Anxiety
- Depression
- Cancerphobia
Nutritional Deficiency – The nutritional deficiencies which causes glossodynia are iron, vitamin B12 and folate deficiency. Glossodynia associated with iron deficiency occurs in 13% of cases. The iron deficiency is low in men (3%), as compared to non-pregnant women (10-30%), and pregnant women (10-60%). Because of glossitis and glossodynia in iron deficiency anemia, the patient may seek dental treatments. The dentist and patient must be aware of signs and symptoms to prevent serious neurological complications of this disease.
Risk Factors
Burning mouth syndrome is uncommon. However, risk may be greater if the patient is –
- A woman
- In postmenopausal period
- In your 50s, 60s or even 70s.
Symptoms
The person having Glossodynia will be able to manifest the following symptoms, which are associated with this kind of condition –
- Burning sensation in the oral cavity especially in the tongue
- Xerostomia or drying of the mouth
- Cotton mouth or lacking of saliva
- Dysgeusia which is the disorientation of taste wherein things doesn’t taste normally as it should be
- Depression
- Chronic anxiety
- Itching of the tongue
- Difficulty in swallowing
- Difficulty in chewing
- Changing in the person’s mood
- Mouth pain
- Difficulty in speaking
- Increase in thirst
- Mild discomfort in the oral region
- Sore mouth
- Numbing sensation of the mouth
The symptoms mentioned are usually not present in the morning but it eventually gets worse as the day goes on. In addition to that, symptoms may be present in other oral location. Also, the patient with this kind of condition will be able to experience remission and exacerbation of the condition which will last to a few months to years.
Complications
Complications associated with this condition may include mood changes, insomnia, or loss of appetite. Those who have a known food allergy, are diagnosed with an upper respiratory tract infection, or are taking certain prescription medications may be at an increased risk for developing glossodynia. Recent dental procedures and unusually high amounts of stress, such as experiencing a traumatic event, also increase an individual’s susceptibility to this condition.
Treatment
The treatment for patients diagnosed with Glossodynia varies from one person to another depending on the severity of the manifesting symptoms, as well as the diagnosis and the underlying etiological factors. Apparently, as of the moment, there is no specific treatment that will cure this kind of condition, however, treatment that will reduce the symptoms that the patient experience can be given and prescribed by a trusted physician. Such treatment includes:
- Mouthwashes
- Vitamin supplements which depends on the deficiency of the vitamin
- Alpha lipoic acid
- Oral thrush medication
- Antidepressant medication
- Vitamin B supplement
- Cognitive behavior therapy
- Psychological medications
- Saliva replacement therapy
- Pain reliever such as capsaicin, a known local anesthesia, which comes from chili peppers
- Oral rinses
- Anticonvulsant medication which is in lozenge form such as clonazepam
- Microsurgeries which are done for nerve damage or neuropathies
- Removal of the dentures or crowns
- Plastic tray will be fitted to be able to correct mouth irregularities
- Antibiotic kind of medication to prevent bacteria to lodge in
- Chamomile mouthwash to be used four or five times a day which improves the symptoms associated with this kind of condition