What is Burning Mouth Syndrome?

Burning mouth syndrome is a condition that is typically characterized by a painful burning sensation across the lips, tongue, palate (roof of the mouth) and the inside surfaces of the mouth. It is most commonly seen in middle aged and elderly women. There are several causes of this condition, but the exact pathology that leads to such symptoms is unknown.

Causes of burning mouth syndrome

• Nutritional deficiencies - Certain vitamin deficiencies may lead to tingling or burning sensations across the mucosal surfaces of the mouth
• Allergic reactions - Allergies to certain foods or medications may lead to intense itching and burning of the internal mouth surfaces
• "Dry mouth" - This is caused by breathing through the mouth rather than the nose and by certain medications or diseases such as Sjogren's syndrome
• Hormonal changes occurring during the menopause may cause the condition in some women
• Dental injury, teeth malocclusion or badly fitted dentures or bridges. Gum disease may also lead to inflammation and burning within the mouth
• Oral fungal infection or candidiasis
• Gastroesophageal reflux disorder

Symptoms of burning mouth syndrome

The main symptom of this condition is severe burning in the mouth. In addition, the following may occur:

• The tip of the tongue may tingle or itch
• The mouth may feel painfully sore or dry
• There may be a bitter or metallic taste in the mouth
• The pain may be either constant or periodic and may last anything from weeks to months or even years
• Due to concomitant chronic pain, people may also feel depressed and anxious

Symptoms usually start late in the morning and may become most severe by the evening. It is usually absent or minimal at night.

Diagnosis

Diagnosis involves a detailed evaluation of the symptom history and associated features. The next step is a detailed examination of the mouth and a general medical examination. Tests that are performed include routine blood tests, an oral swab to detect infections and allergy testing.

Treatment

Treatment is directed at the cause of the condition. For example, if irritating dentures are the cause, they may need to be replaced. Existing medical conditions such as candidiasis and Sjögren's syndrome may need be treated. Drugs that tend to cause dry mouth and therefore burning mouth syndrome may also need to be replaced or their doses adjusted. Associated anxiety and depression is also treated accordingly.

Home management includes:

• Avoidance of hot, spicy foods, acidic fruits, juices, tobacco, alcohol and mouth washes containing alcohol
• Adequate intake of water and sucking on ice cubes occasionally
• Maintenance of adequate oral hygiene through teeth brushing, flossing, and cleaning of any dentures
• Chewing sugarless gum to maintain moisture in the mouth

Sources

1. http://www.ada.org/sections/scienceAndResearch/pdfs/patient_53.pdf
2. www.ouh.nhs.uk/patient-guide/leaflets/files%5C110407burningmouth.pdf
3. onlinelibrary.wiley.com/doi/10.1111/j.1834-7819.2005.tb00363.x/pdf
4. www.digestive-surgery.com/.../TASTE_03.pdf
5. www.nidcr.nih.gov/.../BurningMouthSyndrome.pdf
6. web.squ.edu.om/.../ch34.pdf