Cool Off a Burning Mouth

You wake up in the morning feeling fine.  Then suddenly, out of nowhere, even before you’ve had a cup of coffee or brushed your teeth, a burning sensation hits the tip and maybe even the sides of your tongue and the roof of your mouth.  Though it may disappear during meals, it otherwise seems to keep a schedule of its own.  Some days are worse than others…and some are symptom free.  You’re not alone with these chronic symptoms. 

More than 1 million adults in the United States, mostly women in their post-menopausal years, are affected by a poorly understood and difficult to diagnose condition known as Burning Mouth Syndrome (BMS).  Patients' experience a burning sensation in their mouth, palate, lips and tongue, as well as partial or complete loss of taste, dry mouth and thirst.  Often times it may involve a bitter or metallic taste, or a loss of taste perception.  People who have this condition are often very frustrated because pinpointing the pain source can be a trying task for both the patients and their health care providers. 

The first goal in treatment of BMS is to make sure the symptoms are not due to a larger condition, such as anemia, leukemia, acid reflux, severe vitamin deficiency, undiagnosed diabetes, or a yeast infection of the mouth.  These “other” causes account for only 20 -30% of those affected.  In the other 70 percent where a cause cannot be established, a dentist can help. First, the dentist may recommend chewing sugarless gum, sugarless mints or frequent drinks of water to relieve the discomfort of dry mouth. Second, anti-fungal medications sometimes provide relief, even when there are no visible signs of a yeast infection in the mouth.

Many researchers now believe BMS may be connected with anxiety, stress or depression.  In addition, there is considerable speculation that the condition may be hormonally related since a majority occurs in postmenopausal women. 

Treatments

• Benzodiazepines, like Valium and Ativan, as well as low doses of anti-depressants can help control stress and ultimately relieve pain.
• Creams of lozenges containing capsaicin, the substance that makes chili peppers hot, work by alleviating nerve pain. (I know that one sounds crazy, but it has helped when made in lozenge form in low doses to desensitize the nerves)
• For those in the habit of thrusting the tip of the tongue into the teeth or roof of the mouth, a dental appliance can be fabricated to keep the tongue from touching the teeth that is worn overnight.
• Prescription strength topical anesthetics have met with varying degrees of success.
• The latest treatment being used is alpha lipoic acid, an antioxidant, which is available in pill form over the counter in drug and health food stores.  The assumption, although not proven, is that it will repair nerve damage.

Burning mouth syndrome can be frustrating, but despite the mystery, individuals with even minor symptoms should seek treatment to ensure it is not a sign of a more serious condition.