Why this painful condition occurs and how to manage it
If you’ve not experienced it, burning mouth syndrome (BMS) can sound rather strange. Yet glossodynia, as it’s also known, is fairly common – between 0.75 and 15% of the population are affected by it, with more women experiencing it than men.
The mean age of BMS patients is 50 to 60 years old, and prevalence among menopausal women ranges between 10% and 40%, depending on the research [1].
What is it?
Burning mouth syndrome is a name given to discomfort, pain or burning in your mouth. It is predominately found on your tongue, although can also affect your lips, palate or cheeks or be widespread and felt all over your mouth. It’s described as a burning or scalding feeling but some people also experience a numbness or tingling, a dry sensation or unpleasant taste that’s bitter or metallic. Usually, you would not be able to see any visible changes, or redness in the areas that are painful.
For some, the sensation can come and go, for others it’s continuous, and some people find it builds up during the day then eases at nighttime.
RELATED: altered taste and the menopause
What causes BMS?
BMS occurs when the nerves in your mouth change the way they send message about warmth, cold and taste to your brain. According to the Oral Health Foundation, when the brain doesn’t understand the messages properly, it can cause the feeling of pain. It’s known as a neuropathic pain as it relates to damaged nerves.
No one knows what exactly causes BMS. Some possible causes of BMS include immune system problems, damage to the nerves controlling taste or pain, a reaction to certain types of toothpaste or mouthwash, being allergic to material in dentures, or certain medications such as ACE inhibitors (used to treat high blood pressure).
Various medical conditions can cause it, including dry mouth, acid reflux, thrush infections, nutritional deficiencies (such as iron, vitamin B12 or folic acid) and diabetes.
Hormonal changes - fluctuating and low levels of progesterone, estradiol and testosterone - can also cause burning mouth syndrome. These hormones all work to improve the way your nerves work so when levels are low or changing this can trigger these symptoms.
Related: oral health and the menopause
How is it treated?
If you feel your symptoms may be related to your hormones then you should see a clinician to discuss being prescribed the right dose and type of hormones - progesterone, estradiol and testosterone. This can often really improve symptoms of BMS as well as other symptoms.
A dentist can examine you and help to rule out any other medical or dental causes. If there is a dental cause, such as dry mouth or a fungal infection, they will help resolve this. If they are unable to find a dental cause, it will be referred on to a doctor or oral medicine specialist who can do further investigations, such as a blood sample to check your levels of iron, vitamin B12, folic acid and glucose or further medical investigations.
It’s worth noting that BMS can be a long-term condition – while some people may only experience it for a few months, for others it can take years to disappear, and some have it for the rest of their life. So, it’s important to explore remedies and coping strategies that help you.
Keep your mouth moist by sipping water often, sucking on crushed ice, or chewing sugar-free gum to produce saliva. Avoid irritants such as hot and spicy foods, mouthwashes containing alcohol, acidic fruits or juices, tobacco and alcohol.
Trials have suggested that alphalipoc acid (available in health food shops) may be helpful – 200mg three times a day for a month then once daily.
If a prescribed medicine is causing dry mouth (as this is a common side effect), this may be modified to see if it is contributing to the BMS. Sometimes a mild antidepressant can also be prescribed to help those in severe pain, or feeling low as a result of the long-term symptoms.
Coping strategies, including rest, relaxation, cognitive behavioural therapy, antidepressants and counselling can also be considered. Symptoms can be alleviated when stress over the condition is decreased. It’s also important to note that half of all people with BMS will find it improves or goes away completely.
