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                                                        DR. DAN PETERSON

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BURNING MOUTH SYNDROME

1-5% of the population may have this difficult to diagnose disease

What is Is?

Burning Mouth Syndrome is a common yet complex problem that causes the individual to experience a burning or scalding pain on the lips, tongue and sometimes throughout the mouth.  There are often no visible signs of irritation. The cause of the syndrome may be caused by the onset of menopause to vitamin deficiencies.   About 5% of the population, usually people over the age of 60 are affected with this condition.  It often occurs more frequently in older women , often in menopausal women.

Symptoms:

bulletburning sensation in mouth, throat, lips and tongue.
bulletscalding feeling
bulletdry mouth,
bulletbitter or metallic taste
bullettaste alterations
bulletchanges in eating habits
bulletchanges in medications
bulletpain which can be gradual and spontaneous, intensifying as the day goes on
bulletinterferes with sleep
bulletrestlessness that may cause mood changes, irritability, anxiety and depression

Causes:

  1. Unknown.
  2. Conditions associated with this condition: 
    1. onset of menopause-hormonal changes
    2. diabetes
    3. deficiencies in iron, zinc, folate, thiamin, riboflavin, pyridoxine, cobalamin, vitamin B-12, niacin, iron
    4. complications to cancer therapy
    5. 1/3 of people say BMS symptoms appear shortly after dental procedure, recent illness, or medication course.
    6. anemia
  3. 70% of cases have no specific diagnosis for symptoms and doctors are unable to pinpoint the source, it may occur from:
    1. dry mouth, tongue thrusting
    2. bruxism
    3. irritating or ill fitting dentures
    4. thrush or fungal infections- a yeast infection of the mouth, a course of Mycelex/Nystatin  may help
    5. nerve disorders or damage
    6. psychological factors. depression, anxiety
    7. allergies
    8. acid reflux
    9. dietary deficiency....can be seen in vegetarians
  4. Sensitivity to the material of the denture
  5. Dental trauma
  6. Tobacco
  7. Medications, such as diuretics, oral diabetes medications, and some blood pressure
    medications, as well as various over-the-counter medicines, can cause symptoms of glossodynia.
    IDF
     

Diagnosed:

  Medical history is taken.  Oral causes for BMS will be determined by taking an oral swab or biopsy to check for thrush.  Dry mouth examination along with seeing general physician or specialist for other blood, allergy, liver or thyroid tests.

Possible Treatments: Will vary depending on the cause. For the 70% of people where no diagnosis can be pinpointed, your dentist will treat the symptoms through:

bulletAntifungal therapy
bulletVitamin and mineral replacements
bulletCreams or lozenges containing capsaicin .....low doses of capsaicin (a red pepper derivative that works by overwhelming the mouth by providing the pain with a distraction.).
bulletHormonal replacement
bulletAntidepressants (to mask the burning sensation that occurs on the tongue by changing the brain chemicals) 
bulletMental health counseling
bulletIntraoral appliances
bulletTopical rinses,
bulletAnesthetics,

Thioctic acid may be a treatment for burning mouth syndrome:
Burning mouth syndrome (BMS): double blind controlled study of alpha-lipoic acid (thioctic acid) therapy.

 Burning mouth syndrome (BMS) has features of a neuropathy and could be related to the production of the toxic free radicals that are released in stress situations. Alpha-lipoic acid is an antioxidant able to increase the levels of intracellular glutathione and eliminate free radicals. This study aimed to examine the effectiveness of alpha-lipoic acid in the therapy of BMS. METHOD: This was a double blind, controlled study conducted for two months on 60 patients with constant BMS. Comparing alpha-lipoic acid (test) with cellulose starch (placebo), there was no laboratory evidence of deficiencies in iron, vitamins or thyroid function and no hyperglycaemia. RESULTS AND CONCLUSION: Following treatment with alpha-lipoic acid, there was a significant symptomatic improvement, compared with placebo, with the majority showing at least some improvement after 2 months, thus supporting the hypothesis that burning mouth syndrome is a neuropathy. This improvement was maintained in over 70% of patients at the 1 year follow-up. Femiano F, Scully C. Stomatology Clinic II, University of Medicine and Surgery, Napoli, Italy. femiano@libero.it

One internet writer tells what helped her:

Add 1/2 teaspoon of baking soda to a liter of water and drink it, she believes it changes the PH and helped relieve her BMS. 10/05

Dentalnotes pg 2 Summer 2004

http://www.agd.org/public/oralhealth/Default.asp?IssID=293&Topic=B&ArtID=1141#body

February 06, 2008

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          If you have any questions please e-mail me at: drdpeterson@scottsbluff.net
                                                                                 308-436-3491 Office number

PLEASE NOTE: The information contained herein is intended for educational purposes only.  It is not intended and should not be construed as the delivery of dental/medical care and is not a substitute for personal hands on dental/medical attention, diagnosis or treatment.  Persons requiring diagnosis, treatment, or with specific questions are urged to contact your family dental/health care provider for appropriate care.
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