What is Burning Mouth / Tongue Syndrome?
Burning mouth syndrome (BMS) is a painful, frustrating condition described as a burning or scalding sensation in the tongue, lips, palate, or the entire mouth, usually without clinical and laboratory findings or any detectable reason. Other names for the condition include scalded mouth syndrome and stomatodynia.
The most commonly affected part of the mouth is the tongue. When the painful or burning sensation affects only the tongue, the condition is called burning tongue syndrome or glossodynia.
Burning Mouth Epidemiology
Burning mouth syndrome occurs most commonly in middle-aged or older women. About 5% of the population, usually women after menopause and people over the age of 60 are affected by this condition. Burning mouth syndrome probably represents a number of different conditions with different causes but a common symptom.
The disorder often occurs in conjunction with yeast infections of the mouth (oral thrush) or with xerostomia (dry mouth). Some people experience the burning tongue syndrome symptoms together with actual physical changes of the tongue, a condition called glossitis. It is not clear if these conditions are related or if they just occur at the same time. Glossodynia can be acute (lasting for days or weeks) or chronic (lasting for longer periods of time). The duration often depends on the underlying cause.
Symptoms of Burning Mouth / Burning Tongue Syndrome
Burning Mouth / Burning Tongue Syndrome is a relatively common condition that is characterized by a moderate to severe burning sensation on tongue or other mouth tissues. Patients initially experience a burning, itchy, dry or sticky mouth. Usually this sensation develops in the front part of the mouth, typically affecting the inner surfaces of the lips, the roof of the mouth and the sides and tip of the tongue. The feeling is similar to that which occurs after consuming a hot liquid or food and scalding the mouth.
In some patients, only the tongue will be affected. In this case the condition is described as Burning Tongue Syndrome. In all cases, however, the mucosa of the mouth clinically appears normal.
Other symptoms of Burning Mouth Syndrome include:
- itchy, dry or sticky mouth
- tingling or numbness on the tip of the tongue or in the mouth
- decreased taste ability or altered taste sensation (bitter or salty)
Burning Mouth Syndrome can persist for months or years. Some patients feel constant pain; for others, pain comes and goes or gradually increases throughout the day. Anxiety and depression, as secondary symptoms caused by the chronic pain, are common in people with burning tongue / mouth syndrome.
Diagnosis of Burning Mouth Syndrome
Diagnosis is based on detailed medical history and a thorough oral examination to confirm that the mucosa is healthy by the absence of any other mucosal diseases. Because of the variety of causes that lead to Burning Mouth Syndrome, diagnosis is not enough, without the identification of the underlying causes. If the patient’s history is not enough in identifying the cause, several examinations may be needed, involving various medical professionals. The required examinations include :
- Physical examination of the mouth for rough edges, salivary glands operation, mouth sores etc.
- Blood tests to look for infections, anaemia, nutritional deficiencies, diabetes, hypothyroidism etc.
- Cell culture to identify signs of Candida albicans that causes oral thrush / oral candidiasis.
- Allergy tests to identify possible irritants in foods or denture materials.
Unfortunately, in some cases, even after all the necessary exams, the cause of burning tongue syndrome remains uknown.
What are the Causes of Burning Tongue / Mouth Syndrome?
Burning mouth syndrome may have more than one cause, within a wide range of medical and dental conditions. But for many cases, the exact cause of their symptoms cannot be found. Possible causes of burning mouth syndrome, include :
- Dry mouth syndrome, caused by medications, alcohol and tobacco use, aging.
- Oral thrush, an infection that occurs when the chemical balance of the body is disrupted and the fungus Candida albicans grows out of control.
- Stress / anxiety and depression can also trigger a burning mouth condition.
- Nutritional issues, like deficiencies in iron, zinc, B12, folic acid, and B-complex vitamins.
- Food Allergies. Sensitivities to certain foods, food flavorings, food additives, fragrances, dyes.
- Dentures. Poorly fitting dentures that damage the surface of the mouth’s tissues or sensitivity to their material are common burning mouth causes.
- Blood pressure medications may cause burning mouth as a side effect.
- Hormonal imbalances especially during menopause - Fluctuations in hormones levels and the resulting change in the composition of the saliva cause inflammation in the mouth.
- Acid (gastroesophageal) Reflux Disease. The acidic fluids may cause mouth irritation and pain.
- Nerve damage (neuropathy). Damage to nerves that control taste and pain in the tongue may also result in a burning sensation on tongue.
- Endocrine disorders. High blood sugar levels that occur with conditions such as diabetes and underactive thyroid (hypothyroidism) that alter the chemical balance of the mouth, are also identified as possible causes of burning tongue.
Burning mouth and tongue syndrome is not directly related to any serious condition, such as oral cancer or AIDS. Furthermore it is not contagious, it can’t be passed from one person to another.
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