Burning Mouth Syndrome
Burning mouth syndrome is a general description for many conditions where the patient complains of a burning sensation in the lips, tongue, or entire mouth; the pain tends to become more severe later in the day. It is persistent and can last for years without treatment. It is most common in middle-aged and older women.
The syndrome has many causes, both physical and psychological. This makes the diagnosis difficult because the specific cause must be found before it can be treated. Causes include dry mouth (due to conditions such as diabetes or Sjögren’s syndrome or to long-term use of certain medications), oral candidiasis (thrush), nerve damage, hormonal changes associated with menopause, nutritional deficiencies, acid reflux, poorly fitting dentures, and anxiety and depression.
Diagnosis involves taking a full medical history and performing a thorough oral exam, including taking samples to test for thrush. Blood tests for nutritional deficiencies and allergies are also performed.
Successful treatment of burning mouth syndrome depends on finding and treating the underlying cause, although symptomatic treatment is possible if the cause cannot be found. Dry mouth due to drugs may be alleviated by changing the drugs; medications to treat dry mouth may also be helpful. Thrush can be treated with antifungal agents. Pain due to nerve damage may be treated with painkillers.
Hormonal changes are treated with hormone replacement therapy. Nutritional deficiencies can be addressed with nutritional supplements and advice about diet. Acid reflux is treated with antacids. Poorly fitted dentures can be adjusted or, if necessary, replaced. Psychological causes are treated with psychological counselling or with antianxiety or antidepressant medication. Treatment with benzodiazepines and tricyclic antidepressants has had good results.
Patients can minimise their symptoms by drinking plenty of water, sucking ice chips, chewing gum to encourage salivation, and avoiding spicy foods and alcohol. Rinsing the mouth with a mixture of hot pepper (capsaicin) and water has also been found to be helpful in some cases.
Chetan :: Oct.01.2007 :: Dental Diseases, Dental Syndromes :: No Comments »