Summary about Disease
Burning Mouth Syndrome (BMS) is a chronic (long-lasting) condition characterized by a burning sensation in the mouth, often on the tongue, lips, gums, palate, or throat. The pain can feel like scalding, tingling, or numbness. BMS can occur suddenly or gradually, and the cause is often unknown (idiopathic BMS). While there are no visible signs of inflammation, the discomfort can significantly impact a person's quality of life, affecting eating, drinking, and sleeping.
Symptoms
A burning sensation, most commonly on the tongue but also affecting the lips, gums, palate, throat, or entire mouth
A feeling of dry mouth
Increased thirst
Altered or metallic taste in the mouth
Numbness or tingling in the mouth
Soreness of the mouth
Causes
In many cases, the exact cause of BMS is unknown (idiopathic BMS). However, potential contributing factors and associated conditions include:
Nerve damage: Problems with the nerves that control taste and pain in the mouth.
Nutritional deficiencies: Lack of vitamins, such as B vitamins, iron, or zinc.
Dry mouth: Can be caused by medications, medical conditions, or salivary gland dysfunction.
Oral infections: Such as yeast infections (thrush).
Allergies: Reactions to food, dental products, or medications.
Acid reflux: Stomach acid flowing back into the esophagus and mouth.
Hormonal changes: Such as those associated with menopause.
Psychological factors: Anxiety, depression, and stress.
Dental problems: Ill-fitting dentures or other dental appliances.
Certain Medications: Some medications can cause dry mouth or altered taste, leading to BMS symptoms.
Underlying Medical Conditions: Diabetes, autoimmune diseases, and other systemic illnesses.
Medicine Used
Treatment focuses on managing symptoms as there is no single cure. Medications may include:
Topical treatments:
Capsaicin mouthwash or lozenges
Clonazepam (a benzodiazepine) mouth rinse
Lidocaine mouthwash
Systemic medications:
Antidepressants (tricyclic antidepressants, SSRIs)
Anticonvulsants (gabapentin, pregabalin)
Alpha-lipoic acid
Clonazepam (oral)
Saliva substitutes: For dry mouth
Nutritional supplements: To address any deficiencies
Pain relievers: As needed for symptom control (use with caution)
Is Communicable
No, Burning Mouth Syndrome is not communicable or contagious. It cannot be spread from person to person.
Precautions
Avoid irritants: Avoid spicy foods, acidic foods and drinks, alcohol, and tobacco.
Maintain good oral hygiene: Brush gently with a soft-bristled toothbrush and use fluoride toothpaste.
Drink plenty of water: To keep the mouth moist.
Chew sugar-free gum or suck on sugar-free candy: To stimulate saliva production.
Manage stress: Practice relaxation techniques such as meditation, yoga, or deep breathing.
Review medications: Discuss any medications with your doctor that may be contributing to dry mouth or BMS symptoms.
Address underlying medical conditions: Seek treatment for any underlying conditions, such as diabetes or acid reflux.
Consider dietary changes: If food allergies are suspected, work with a doctor or allergist to identify and avoid trigger foods.
How long does an outbreak last?
BMS is a chronic condition, not an "outbreak." The duration of symptoms varies significantly. For some, the burning sensation may be constant; for others, it may come and go. Symptoms can last for months or even years.
How is it diagnosed?
Diagnosis is often based on exclusion, meaning other potential causes of oral pain are ruled out first. Diagnostic steps may include:
Medical history and physical exam: Including a thorough review of symptoms, medications, and medical conditions.
Oral examination: To look for signs of oral infections, inflammation, or other abnormalities.
Blood tests: To check for nutritional deficiencies, diabetes, thyroid problems, and other underlying conditions.
Salivary flow test: To measure saliva production and diagnose dry mouth.
Allergy testing: If food allergies are suspected.
Oral cultures: To check for oral infections, such as yeast infections.
Neurological evaluation: In some cases, to rule out nerve damage.
Psychological evaluation: To assess for anxiety, depression, or other psychological factors.
Burning Mouth Syndrome (BMS) Questionnaires: To assess the severity of symptoms.
Timeline of Symptoms
The onset of BMS symptoms can be sudden or gradual. The timeline varies from person to person:
Onset: Symptoms may appear spontaneously or be triggered by a specific event (e.g., dental work, illness, medication change).
Progression: The burning sensation may start mild and gradually increase in intensity over time.
Fluctuation: Symptoms may be constant or intermittent, with periods of remission (reduced symptoms) and exacerbation (worsening symptoms).
Duration: Symptoms can persist for months or years if untreated.
Important Considerations
Psychological impact: BMS can have a significant impact on a person's mental and emotional well-being, leading to anxiety, depression, and social isolation.
Quality of life: The discomfort and pain associated with BMS can interfere with eating, drinking, sleeping, and other daily activities.
Multidisciplinary approach: Effective management of BMS often requires a multidisciplinary approach involving doctors, dentists, neurologists, psychologists, and other healthcare professionals.
Ruling out other conditions: It's important to rule out other possible causes of oral pain before diagnosing BMS.
Finding the right treatment: There is no one-size-fits-all treatment for BMS. It may take time and experimentation to find the most effective combination of therapies.
Support groups: Joining a support group can provide emotional support and connect individuals with others who have BMS.
Long-term management: BMS is often a chronic condition that requires long-term management.