Burning Mouth Syndrome – Causes & Treatment
Burning Mouth Syndrome Causes
No one seems to know exactly what causes BMS, but it appears that the nerves in your mouth have run-a-muck and are transmitting pain signals, when there are no painful stimulus. The following may be some triggers responsible for the abnormal transmission of nerve pain stimulus:
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Menopause, possibly due to the fluctuation of hormones.
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Severe stress, such as job loss, death of a loved one, anxiety, depression, post-traumatic stress disorder, TMJ (jaw joint) problems, chronic fatigue syndrome, and fibromyalgia.
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Irregular sleep patterns and not enough restful uninterrupted sleep, chronic headaches, fatigue, back pain, irritable bowel syndrome, panic attacks, and ringing in the ears can also trigger BMS.
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Allergies to dental metals used for fillings and caps, dental products, flavor in toothpaste or foods. It's best to always use a flavorless toothpaste.
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Nutritional deficiencies, such as low levels of vitamins B and iron.
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Dry mouth caused by certain disorders, such as Sjorgren's syndrome or as a side effect of certain drugs.
Certain conditions and diseases in the mouth may trigger BMS, including:
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Oral yeast infection, also known as candidiasis or oral thrush, appears as white patches on different surfaces in the mouth. You may be at higher risk with oral yeast infection if you are receiving chemotherapy or radiation treatment for cancer, have HIV infection, receiving organ transplantation, wearing dentures or taking long term steroids or antibiotics.
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Oral lichen planus affects the lining mucosa of the mouth. Weakened immune system and genetics may play a part in this disease. Your body's white blood cells attack the cells lining the mouth, causing some researchers to believe oral lichen planus is an autoimmune disorder.
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Geographic tongue is an inflammatory condition that gives the tongue a map-like appearance and may also be a trigger for burning mouth. The appearance of the tongue shows varying sizes of bald areas with white borders. It's not known what causes geographic tongue, but stress, allergies, diabetes and hormonal disturbances may be some factors for this condition.
Symptoms of Burning Mouth Syndrome
The symptoms are usually mild or slight on waking in the morning, but more burning develops as the day goes on and specially in the evening. Burning is felt on the tip and sides of the tongue, top of the tongue, roof the mouth and the inside of the lips. Burning mouth syndrome is described as either a primary or secondary type.
Primary BMS explains the cause of symptoms from damage to the nerves that control pain and taste in your mouth.
Secondary BMS means there are medical conditions that are causing the symptoms. Treating those medical conditions, will cure secondary BMS. Factors that trigger secondary BMS include:
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Endocrine disorders, such as diabetes or thyroid (hypothyroidism) problems causing hormonal changes
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Allergies, specially to certain dental materials
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Medications, such as for high blood pressure known as angiotensive-converting enzyme (ACE) inhibitors
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Acid reflux resulting in acids that enter your mouth from your stomach
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Habits such as grinding and clenching the teeth, biting the tip of the tongue, or tongue thrusting
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Irritating your mouth by using abrasive toothpaste, over-using alcohol mouthwashes, too many acidic drinks such as sodas or sucking on lemons
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Deficiency in zinc, iron and vitamin B-9 (folate), vitamin B-1 (thiamin), vitamin B-6 (pyridoxine) and vitamin B-12 (cobalamin)
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Ill-fitting dentures that irritate the mouth, or place stress on particular muscles and tissues of your mouth
Burning Mouth Syndrome Treatment & Remedies
There is no cure for BMS. However, diagnosing and addressing the secondary underlying medical conditions, can help alleviate the symptoms and bring relief. For example, if anxiety or depression is treated with medication, the discomfort from BMS is also eliminated. Primary type of BMS caused by nerve damage is helped by low doses of medications typically used for anxiety or depression. For example, clonazepan, amitriptyline, nortriptyline doxepin or gabapentin are either used as a mouth rinse or are dissolved into the mouth to reduce the activity of the nerve fibers.
Who to see for diagnosis and treatment can be a challenge. General dentists and physicians typically do not treat BMS. Oral Surgeons and Oral Medicine specialists are your best choice to seek help from for BMS. Most major dental universities have such a department as Oral Medicine, with a few in private practice.
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Always choose a mint-free toothpaste and alcohol-free mouthwash for dry mouth.
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Hormone replacement therapy has not been shown to be effective in managing BMS in post-menopausal women.
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If you notice there is no burning in your mouth on waking in the morning, but that pain gets worse as the day progresses, the cause may be nutritional deficiency or diabetes. Treating these conditions will help the BMS symptoms.
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If you don't notice symptoms at night, but only throughout the day, chronic anxiety or stress may be the cause of the BMS, and treating them will help manage the BMS symptoms.
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Some people report drinking cold water or ice cubes help with the pain.
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Avoid any irritating substances, such as alcohol, tobacco, spicy foods, or other high acid foods such as tomato juice.
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If your symptoms come and go and you even have some good days free of any symptoms, it's possible the cause is food allergies.
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To help with pain, sip on a cold beverage, or suck on ice chips.
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Chewing on gum with xylitol is also helpful, since it helps flow of saliva.
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Avoid irritating things such as tobacco, hot, spicy foods, alcohol drinks or mouthwash with alcohol.
Besides treating the underlying medical condition, lifestyle management is extremely important, since BMS is not an overnight condition but can last for a very long time. Manage stress by balancing fun and work, eat proper nutrition, seek counseling as needed, exercise, and use medication that can help you become free of BMS symptoms.
