Burning Mouth Syndrome is a term used to describe a perplexing syndrome of uncomfortable intraoral mucosal irritation and burning that is not clearly understood to date. It presents more in women, often within 3 yrs prior to and up to 12 years after menopause. In over 50% of these patients, the onset is usually sudden and without any specific cause. About 30% of patients decribe association with recent dental procedure, recent illness, or completion of a medication course (including antibiotics). Once it starts it can persist for years although, mysteriously, spontaneous recovery within 6-7 years is seen in over 60% of affected patients. During this time, however, these patients are often referred from one doctor to another without successful resolution of the pain.
Recent studies have shown a possible close connection to a cranial nerve irritation (neuropathy) involving cranial nerves V, VII, and IX which all innervate the face and intraoral tissues. The mucus membranes of the anterior 2/3 of the tongue, anterior hard palate, and the lower lip are most commonly involved. There is also an apparent relationship with distorted taste and dry mouth that may allow loss of inhibition of the cranial nerve V pain fiber pathways that actually increases the burning sensation experienced by these patients.
A recent study showed that discontinuing ACE inhibitors in patients taking this medicine with the syndrome resulted in disappearance of pain within several weeks. Candida (yeast) infection within the oral cavity is also thought to be a possible contributing inflammatory factor seen with this syndrome.

Treatment is currently limited to addressing the areas and tissues involved and include:
1.Hormone replacement when indicated for menopausal symptoms.
2.Nutritional oral supplementation for any vitamin or mineral deficiency.
3.Antifungal medications for intraoral yeast infection.
4.Cranial neuropathy and antidepressant medications (Neurontin, Klonopin, Benzodiazepines) 
5.Stopping or changing any medication thought related to exacerbating the pain.
6.Capsaicin (hot pepper) mixed with water for distorted taste (dysguesia) frequently seen with the syndrome.
7.Increased hydration to prevent dehydration and dry mouth which aggravates the burning sensation. 

A complete and thorough examination by a head and neck specialist is critical to eliminate other causes of intraoral pain involving the tongue, palate, and lips.  Call our office for an appointment with Dr. Sciacca if these symptoms are present and a thorough ENT exam has not been performed

For more information

4501 Southlake Pkwy
Suite #200
Hoover, AL 35244