A colleague seemed to be upset. On asking she told that she has a very irritating health problem. She experiences burning sensation in the mouth which slowly spreads to the insides of the cheek, roof of the mouth, lips, and tongue. To get rid of this, she frequently rinses her mouth with cold water but the burning persists. If you know somebody who suffers from the same problems tell him/her to consult their doctor, as it can be a condition called Burning Mouth Syndrome which is also called as glossodynia, stomatodynia, scalded mouth syndrome or burning lips syndrome.
Understanding burning mouth syndrome
The burning mouth syndrome can occur as soon as you wake up in the morning which gradually increases as the day progresses. The burning sensation may be intermittent during some days or totally absent on some days. The burning sensation affects lips, tongue, throat, gums, and palate. There could be a tingling numbness on the tip of your tongue. The other symptoms include increase of thirst, loss of taste sensation, sore mouth and bitter or metallic taste in the mouth. The burning mouth syndrome does not cause physical changes in the body, but the burning sensation can continue for years together.
Causes
When the cause of the burning mouth syndrome is unknown, then it is known as primary burning mouth syndrome which could be related to problems with the sensory nerves of the peripheral and central nervous system or problems related to taste.
If the burning mouth syndrome occurs due to an underlying medical problem, then it is called as secondary burning mouth syndrome. The conditions that can cause burning mouth syndrome include
- Oral infections caused by yeast (thrush), lichen planus or geographic tongue(inflammatory condition of tongue)
- Dry mouth or xerostomia
- Nutritional deficiencies of B complex (vitamin B-1,B-2,B-6,B-12) or zinc and iron
- Anxiety and depression
- Ill-fitting dentures that are causing stress to tissues
- Damage of nerves that control pain and taste
- Allergy to food substances, flavoring agents and additives
- Use of high blood pressure medications like angiotensin enzyme converting inhibitors
- Gastroesophageal reflux (acid from stomach goes back into esophagus)
- Bruxism( teeth grinding) and tongue thrusting
- Endocrine disorders like hypothyroidism and diabetes
- Imbalance of hormones during menopause
- Irritation of mouth due to excess use of mouth washes and brushing too much
Diagnosis
Your dentist or doctor may conduct a variety of tests to identify the cause of your symptoms. Blood tests are recommended to check the thyroid function, level of glucose in the blood, complete blood picture, functioning of the immune system and to know the nutritional factors that may be causing burning mouth syndrome. Imaging tests like CT scan, MRI scan are done to check for any health problems. Sample of saliva is taken and cultured to check if you have any viral, bacterial or fungal infection. Tests of saliva can also tell you if your flow of saliva is reduced making it a dry mouth (xerostomia). The doctor may recommend allergy tests to check if you have allergy to any food substances or dentures. A test called Gastric reflux test can be conducted to see if you are suffering from gastroesophageal reflux disease (stomach acid goes back into esophagus). To check if you are suffering from conditions like anxiety or depression a questionnaire is given to you to answer.
Treatment
For primary burning mouth syndrome, there is no known treatment. To find an effective cure is difficult but you can try a combination of treatments that include anticonvulsant medication like clonazepam (lozenges form), medication for oral thrush, antioxidant like alpha lipoic acid, antidepressants, B complex vitamins, oral rinses, saliva replacement products, pain reliever like capsaicin( derived from chillies) and cognitive behavior therapy (positive thinking is taught by psychologist).
Self help measures
To keep burning mouth syndrome away, it is recommended that you drink lot of water or fluids or suck on ice chips to prevent dry mouth. You must avoid tobacco, spicy foods, cinnamon or mint products, acidic foods like orange juice, tomatoes, and coffee and soft drinks. Change your toothpastes every month. People who wear dentures, should keep their dentures clean. Stress reduction techniques like deep breathing, yoga and meditation may also help. You can ask your doctor to recommend support groups that you can join where you can share your experiences with people suffering from the same condition and also learn new coping skills from them.