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Thursday, December 18, 2014
What is burning mouth syndrome?
Burning mouth syndrome (BMS) is a relatively common problem. Patients who have this condition complain of abnormal sensations of the lining of the mouth. Many patients say that it feels like their mouth has been scalded, and that is why this condition is called burning mouth syndrome. Although we don't know exactly what causes BMS, most of the evidence points to a problem with the nerves that send information about our senses to the brain. These nerves are simply sending incorrect messages to the brain. Different sets of nerves send information about pain, taste, and texture, and any combination of these nerves can be affected for a particular patient.
Pain. A raw, irritated or burned sensation often develops in the front part of the mouth, usually affecting the inner surfaces of the lips, the roof of the mouth, and the sides and tip of the tongue. In some patients, only the tongue will be affected; however, any combination of these sites may be present. Sometimes the burned sensation will be in other areas of the mouth too, such as the throat, the gums, or the cheeks.
Taste. If the nerves that carry information about taste are affected, patients may have a decreased ability to taste their food, or they may develop what are known as "taste phantoms". The person may have a bitter, metallic, salty, sweet or sour taste in the mouth, even though there are no foods or beverages in the mouth to give that taste. It's just that the nerves seem to be telling the brain that a bitter or metallic substance is in the mouth, when in fact, there isn't.
Texture. Other patients may have unpleasant textures in their mouth. For example, they may feel that their mouths are too dry or too wet. They may feel that the lining of the mouth feels slimy or sticky. Some patients have described their mouths as feeling like cotton or Velcro. Sometimes it feels that the lips or tongue are swollen. In all cases, however, the lining of the mouth appears normal when we examine it carefully.
The symptoms of BMS often tend to wax and wane. Patients may describe their sensations as being less obvious in the morning when they first get up, and becoming worse as the day goes on. Usually the irritation is not so bad that it causes them to lose sleep. Some patients will say that the problem will be bad for a few weeks, then gradually fade, only to come back again.
Who gets burning mouth?
Most patients who see doctors for BMS are post-menopausal women, but men can get this problem too. We don't know whether this is because more women have the condition, or just that women are more likely to go to a doctor for evaluation. BMS is a relatively common problem that is seen all over the world. For example, in Holland, patients with BMS have formed a support group. Chat groups have also been organized on the Web. This condition affects people of all races and all backgrounds.
What causes burning mouth?
Nobody knows for sure. There are a few uncommon diseases that could be tested for in some patients, such as anemia, diabetes and oral yeast infections. For most patients with BMS, however, those tests turn out to be normal. We know that burning mouth is not related to anything serious, such as cancer or AIDS. Furthermore it is not contagious - it can't be passed from one person to another.
How do doctors diagnose burning mouth syndrome?
BMS is diagnosed by listening carefully to the patient's description of their symptoms and doing a careful examination of the mouth. Sometimes it may be helpful to do blood tests and fungal culture to make certain that one of the other problems mentioned previously is not present. If those tests are all negative, and if the lining of the mouth appears normal, then we can make a diagnosis of BMS.
How is burning mouth syndrome treated?
Unfortunately, no one has developed a medically proven treatment for BMS. The main problem is that we don't know exactly what causes BMS, therefore it is difficult to develop a treatment for the problem. A variety of medications, including antidepressants, anti-seizure drugs, female hormone replacement therapy and vitamin therapy, have been tried; however, such treatments either have no effect or their effect is no different than what we would expect to see with placebo (sugar pill) treatment.
How long will the burning sensation last?
Again, we cannot say for sure. We know that for about half of affected patients, the condition will resolve after a period of time, but no one can predict how long that will be for a particular individual. For the most part, this problem is a nuisance, and it can be a frustrating situation for both patients and doctors.
This article is a NetWellness exclusive.
Last Reviewed: Aug 12, 2014
Carl M Allen, DDS, MSD
Professor Emeritus of Oral Pathology
College of Dentistry
The Ohio State University
John R Kalmar, DMD, PhD
Clinical Professor of Pathology
College of Dentistry
The Ohio State University