Burning Mouth Syndrome

Oral Surgeon in Racine

Burning mouth syndrome (BMS) is defined by oral surgeons as a burning sensation of the lining of the mouth in the absence of specific oral sores or lesions. There are a number of theories thought of by oral surgeons as to the underlying causes, but a specific cause and effect, or a specific cure is not known. As oral surgeons, we do see this disorder more in individuals with autoimmune complex disorders. The nerve “endings” or receptors in the oral tissues are likely altered in density (increased numbers) or reactive capacity (sensitivity). Risk factors for BMS include stress, anxiety, female gender, menopause, and advanced age.

Burning Mouth Syndrome by the Oral Surgeon

The disorder is characterized by a burning or itching sensation typically involving the more forward structures in the mouth including the inside of the lips, tongue tip and sides, and the front of the palate. No clinical changes in the tissues are seen. Sometimes there are alterations in taste and a sensation of a dry mouth. Most cases involve both sides of the mouth. Most patients are female between the ages of 40 and 60. The burning sensation is continuous and it may show some increase in intensity as the day goes on. It rarely causes sleep disturbances and is typically relieved by eating or drinking.

There may be metabolic changes due to psychogenic processes, but local causes have been identified, in particular anti-hypertensive drugs. In an article from 2008, anti-hypertensives as well as certain anti-depressants, anxiolytic, and anti-retroviral drugs are implicated. (Med Oral Patol Oral Cir Bucal, 2008 Mar 1;13(3):E167-70). Drug sensitivity and drug allergy remains my main suspect when I see cases. Oral surgeons have been able to solve some problems by changing medications. It does take some detective work and cooperation of the prescribing doctors.

Certain preservatives and food additives have been implicated and as an oral surgeon, I do see a crossover between BMS and certain types of allergic responses. Sensitivity to food additives has been reported as being the most common cause when the pain is intermittent and in unusual locations such as under the tongue.

A sedative mouth rinse made up of equal parts Benadryl, Maalox, and Viscous Xylocaine can be used for temporary relief, however this is not a satisfactory treatment or solution. Again, good detective work as an oral surgeon to the underlying problem, sensitivity, or psychogenic concern is needed. As patients, we do need to take initiative with vague problems like this and try to identity when it occurs and possible causes. Make sure to work with your physician if you are going to alter your medications or if you want to try some alternative medications. The above mentioned article may be a good starting point.

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