Burning Mouth Syndrome All You Need to Know
The only people reading this are likely those that are concerned with Burning Mouth Syndrome (BMS). This is a summarization of the basics you need to know without getting lost knee deep in fluffy research articles that are miles long.
Who Usually Gets BMS?
Females around the menopausal age are more vulnerable than any other population group. The etiology is commonly nerve related but most cases of BMS are unfortunately idiopathic, meaning the source of how you got it is unknown.
Who Takes Care of You?
We imagine since burning is in the mouth that it should be a “mouth” issue only but in reality it could be an array of systemic issues. To truly diagnose it would entail extensive testing, labs, biopsies, CTs or MRIs, possible injections or strong medications to rule out alternatives. We can alleviate mild symptoms in office, but we recommend seeing an ENT or family practice doctor for testing and labs to discover the origin of BMS. The challenge we have in southern Oregon is that we do not have any "oralfacial pain specialists" who are the primary sub specialists that typically deal with BMS.
Do I Have Burning Mouth Syndrome?
The title gives it away on what the symptoms are. Usually no visible lesions or markings are present in the mouth. We have found a commonality among our patients that when they complain of a “burning” it usually is a neurological condition, but this is not a hard-fast rule. Symptoms can also range from randomly sporadic to every second of each day:
Burning on your tongue mostly but it can also include the lips, cheeks, and/or gums. The tip of the tongue is most common followed by the anterior portion of the palate
Altered taste--this can be a bitter, metallic, or loss of taste in general
Sensations can range from a simple tingling to burning or stabbing sharp pains
Factors that Accentuate BMS
The following don't cause BMS but are more common factors that aggravate or accentuate BMS:
Blood pressure medications (note that over 400 meds and radiation therapy have been associated with BMS too)
Fungal infections like oral thrush (if antibiotics were recently taken then this could be a causative agent of BMS)
Stress, depression, or anxiety
Menopause--up to 20% of these women experience burning mouth syndrome
Health conditions in particular: autoimmune disease (i.e. lupus, sjogren's), Parkinson's disease, fibromyalgia (nerve pains), UNCONTROLLED diabetes, GERD, or thyroid (hypothyroidism)
How to Treat or Manage it
BMS is similar to dry mouth issues--very challenging to cure so the goal is more focused on managing the symptoms. We recommend trying all or some until BMS becomes manageable:
Avoid toothpastes with sodium lauryl sulfate. Good toothpastes are: Prevident 5,000 Dry Mouth, Biotene, any Sensodyne brands, Equate Maximum Strength Sensitive, CloSYS, Therabreath, or nearly all "natural" toothpastes but not those do not contain fluoride.
Brush with natural baking soda in the evening and regular toothpaste in the morning
Avoid mouthwashes with alcohol (i.e. Peridex and Listerine). If those don't help, Dr. Nelson may prescribe "magic mouthwash"
Avoid carbonated beverages, spicy food, and known acidic foods (i.e. juices or citrus fruits)
We can prescribe a mild sedative like valium to help relax the nerves
Fabricate a night guard that you wear when sleeping, which may be causing nerve complications if clenching at night
Have your medical provider assess your medications especially any blood pressure meds
Beyond our scope of practice but a physician may prescribe a combination of drugs: antihistamines, benzodiazapines, antidepressants, and psychotropic drugs.