For sufferers of burning mouth syndrome (BMS), the constant pain afflicting their lips and tongue (and at times the entire mouth) can be unbearable. They know their condition is real and chronic, but modern medicine, which has no verifiable explanation for why BMS occurs and no reliable cure, often dismisses the ailment as psychological in origin. Doctors can link BMS to known conditions like thrush, to various drug reactions, and even to ill-fitting dentures, but the only current treatment for BMS is to address underlying contributing conditions that may or may not be responsible for the burning. Consequently, many patients are left to deal with the impact of BMS in their lives literally for years.
Women Contract BMS More Often than Men
Women are more likely to be afflicted with BMS (also known as scaled mouth syndrome, glossodynia, and stomatodynia) although approximately four percent of adults in the United States have the condition. It normally comes on in middle age, initially presenting with a dry, itching sensation similar to that caused by drinking a hot liquid or food and scalding the mouth. In addition to the burning sensation, patients describe numbness at the tip of the tongue and a bitter, metallic taste. For some, the pain disappears after a good night’s sleep and comes back during the day, while in other cases the pain is constant.
The Causes of BMS
More than a third of the people with BMS report multiple triggers for severe outbreaks of the condition. Some common causes include:
– Medications: Common culprits are antidepressants, antihistamines, and blood pressure medications (angiotensin-converting enzyme inhibitors). Frequently when the medication is discontinued, the burning resolves.
– Thrush: Like medication-based reactions when the overgrowth of the fungus Candida albicans in the mouth and throat is cured, the burning also goes away.
– Psychological: The emotional factors behind BMS are the least understood. In some instances the anxiety places stress on already damaged nerves and irritation results. Nerve damage can be caused by injury, by complications from a dental procedure, by poor diet, or by medications.
– Nutritional: Nutritional issues related to BMS include deficiencies in iron, zinc, and B vitamins (1, 2, 6, and 12). Food allergies, especially those related to food coloring, fragrances, and other additives have been directly linked to BMS, as has the acrid, bitter fluid that floods the mouth from acid reflux disease.
– Dentures: Poorly fitting and maintained dentures can not only damage the surface of the mouth’s tissues from friction and rubbing, but can also be a breeding ground for fungus and bacteria.
– Repetitive Habits: Chewing the inside of the cheek, tongue thrusting, or teeth clenching can all cause sufficient nerve and tissue damage to trigger burning mouth.
– Imbalances: The high blood sugar present in diabetes can be responsible for BMS as can the hormonal imbalances of menopause. The belief is that the fluctuations in hormones and the resulting change in the chemistry of the saliva cause inflammation in the mouth.
Doctors will conduct an oral exam and ask for a complete description of oral habits and care including things like toothpaste used and the strength of the bristles on your toothbrush. Blood work will be done to check for infections, anemia, nutritional deficiencies, and diabetes. Allergy tests are also conducted and swabs will be taken to rule out the presence of yeast. Because BMS is so hard to pin down, patients are often shuttled back and forth among their dermatologist, dentist, psychiatrist, psychologist, and general practitioner.
Common attempted treatments include discontinuing or altering medications, prescribing nutritional supplements, treating thrush with oral antifungals such as Mycostatin or Diflucan, or altering the adjustment of the patient’s dentures. Since antidepressants are known to contribute to BMS, patients with psychological issues must seek non-chemical relief through therapy, meditation, or other stress-reduction venues.
Even in the absence of a confirmed diagnosis of thrush, burning mouth may be treated as a fungal infection. Fungicides, however, can damage the liver and should not be used long term. Many people prefer to take the appropriate supplements and to use various coping measures like avoiding acidic drinks and cigarettes.
Sugar free gums and chewing on or sucking ice chips can provide temporary relief. Also use baking soda to brush your teeth instead of commercial toothpaste. Herbal remedies or the use of alpha lipoic acid may also lessen symptoms. Regrettably, however, many patients are simply forced to learn to live with BMS long-term.