Scala A, Checchi L, Montevecchi M, Marini I, Giamberardino MA. 2005 Jun 25;149(26):1482; author reply 1482. All rights reserved. Irritation in the Mouth Your mouth may irritate usually because of brushing your tongue longer, drinking acidic beverages, using more than necessary mouthwash and brushing with an abrasive toothpaste. Medications, protease inhibitors, and angiotensin-converting-enzyme inhibitors. An accurate diagnosis of the underlying cause of your pain or discomfort is vital to determining appropriate treatment. There has also been no clear consensus on the etiology, pathogenesis or treatment of burning mouth syndrome.4 As a result, patients with inexplicable oral complaints are often referred from one health care professional to another without effective management. Primary BMS explains the cause of symptoms from damage to the nerves that control pain and taste in your mouth. What are the common causes of burning mouth syndrome? Burning Mouth Syndrome (BMS): Based on her history, clinical features and response after drug cessation, a final diagnosis of selective serotonin reuptake inhibiter (SSRI) antidepressant-induced BMS was arrived upon. This situation not only adds to the health care burden of these complaints but also has a significant emotional impact on patients, who are sometimes suspected of imagining or exaggerating their symptoms. [Burning-mouth syndrome: consideration of maintenance factors]. This article describes an unusual case of a patient who developed symptoms of BMS as a result of antidepressant treatment. Chronic dry mouthcan contribute to burning, tingling orsensation, or soreness in your mouth. Deficiencies of vitamin B and minerals, such as iron and zinc, can contribute to aburnt tongue sensation. 1996-2022 MedicineNet, Inc. All rights reserved. due to anemia). Primary BMS presents with no underlying medical conditions or apparent cause. The causative drugs include angiotensin-converting enzyme inhibitors, anticoagulants, antipsychotics, antiretrovirals, and benzodiazepines. Klasser GD, Fischer DJ, Epstein JB. Once any underlying causes are treated, burning mouth syndrome symptoms may get better. official website and that any information you provide is encrypted This improves the depressive state of the patient [15]. The search was carried out in April 2007. The exact cause for burning mouth syndrome is unknown. These include the following: efavirenz, clonazepam, hormonal replacement therapies, fluoxetine, sertraline and a broad range of antihypertensive agents such as captopril, enalapril, and lisinopril [11]. Gerodontology. Thirty-three percent of drug-induced BMS have been seen to be dose-dependent phenomena, because the burning sensation appears after elevating the drug dose in search of increased therapeutic efficacy [12]. Epub 2017 Oct 18. Learn more It's best to work with your medical professional for guidance on the best treatment for your specific health history and condition. BMS may be primary or secondary to other diseases. Because of a long-standing difficulty in understanding the pain of burning mouth syndrome and its complex clinical picture, a number of etiologies have been suggested. The patient had witnessed an accident and suffered from major depression 3 years prior to visiting our clinic. Burning mouth syndrome (BMS) is a burning, tingling or scalding sensation in the mouth, lasting for at least four to six months, with no underlying known dental or medical cause. Certain blood pressure medications may cause burning mouth symptoms. ), Although benzodiazepines might exert their effect on oral burning by acting as a sedative-hypnotic, this possibility appears to be unlikely because the maximal effect of clonazepam is usually observed at lower dosages.3 The beneficial effects of tricyclic antidepressants in decreasing chronic pain indicate that, in low dosages, these agents may act as analgesics.30. Lauria G, Majorana A, Borgna M, Lombardi R, Penza P, Padovani A, et al. One possible cause of this medical condition . It often presents most commonly as a burning sensation on the tongue, roof of the mouth, or lips. Although candidiasis can cause burning pain, its prevalence has not been found to be increased in patients with the disorder compared with control populations.5,8. YYYY Colgate-Palmolive Company. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Most studies have found that oral burning is frequently accompanied by other symptoms, including dry mouth and altered taste.5 Alterations in taste occur in as many as two thirds of patients and often include complaints of persistent tastes (bitter, metallic, or both) or changes in the intensity of taste perception. Substitution of medications that may cause oral burning (If an ACE inhibitor, ARB, or antiretroviral is suspected, trying . Secondary BMS requires appropriate diagnosis and treatment of the underlying condition to manage symptoms. When in doubt, ask your dental professional for advice. There are two types of BMS, primary and secondary. The .gov means its official. Burning mouth syndrome is characterized by a burning sensation in the tongue or other oral sites, usually in the absence of clinical and laboratory findings. Ensure you're eating a well-balanced diet, includingfresh fruits and vegetables, whole grains, dairy, nuts, seeds, and healthy proteins. Type 2 involves continuous symptoms throughout the day; whereas type 3 features intermittent symptom-free periods throughout the day. PMC These include: Oral Health Problems Oral problems such as Dry Mouth, oral thrush, geographic tongue and oral lichen planus can all cause burning. Other symptoms include: A sensation of dry mouth with increased thirst. Consider over-the-counter options, including pain relief, saliva replacement products, or topical capsaicin. What are the potential causes, and how do they result in discomfort? Burning mouth syndrome: an enigmatic disorder. Rinse mouth with 1 teaspoon of a 1:2 dilution (or higher) of hot pepper and water; increase strength of capsaicin as tolerated to a maximum of 1:1 dilution. Patients with burning mouth syndrome are also more likely to have a psychiatric comorbidity, such as depression or anxiety, but this is not thought to be the cause of the disorder. Update on burning mouth syndrome: overview and patient management. are other findings that are not consistently supported by the literature.5, Despite reports suggesting a significant relationship between burning mouth syndrome and mucosal ulcerative or erosive lesions, periodontitis and geographic tongue,16 most studies have reported no significant changes in intraoral soft or hard tissues.8,9 Similarly, chemical irritation and allergic reactions to dental materials and galvanic currents between dissimilar metals have not been found to be important causes of burning mouth syndrome.16, Hormonal changes are still considered to be important factors in burning mouth syndrome,5 although there is little convincing evidence of the efficacy of hormone replacement therapy in postmenopausal women with the disorder.17 Approximately 90 percent of the women in studies of the syndrome have been postmenopausal, with the greatest frequency of onset reported from three years before to 12 years after menopause.8, It is not surprising that dry mouth has been suggested as an etiologic factor, in view of the higher incidence of this problem in patients with burning mouth syndrome.8,9 However, most salivary flow rate studies in affected patients have shown no decrease in unstimulated or stimulated salivary flow.5 Studies have demonstrated alterations in various salivary components, such as mucin, IgA, phosphates, pH and electrical resistance.5 The relationship of these changes in salivary composition to burning mouth syndrome is unknown, but the changes may result from altered sympathetic output related to stress,6 or from alterations in interactions between the cranial nerves serving taste and pain sensation.18. Dry Mouth (xerostomia) Oral Candidiasis (Oral Thrush) Risk Factors BMS risk factors include Gender MedicineNet does not provide medical advice, diagnosis or treatment. Your dental and medical professionals are there to help identify what's going on and find options to manage your pain or treat its underlying causes. Additionally, it is believed that some medications may cause BMS as a side effect. The site is secure. Talk to your doctor before taking nutritional supplements. What Is Burning Mouth Syndrome? Deficiency of folic acid, iron or various B vitamins (glossitis e.g. Levenson JL. Grushka M, Epstein JB, Gorsky M. Burning mouth syndrome. The treatment of burning mouth syndrome is usually directed at its symptoms and is the same as the medical management of other neuropathic pain conditions (Table 2). Topical capsaicin has been used in some patients. Mayo Clinic has major campuses in Phoenix and Scottsdale, Arizona; Jacksonville, Florida; and Rochester, Minnesota. Additional symptoms of BMS may include dry mouth, altered taste, difficulty sleeping, mood changes, anxiety, and depression. Received 2014 Jan 10; Revised 2014 Mar 21; Accepted 2014 Mar 29. Salivary secretion appeared adequate, and saliva was thin and copious. Rang HP, Dale MM, Ritter JM, Flower RJ, Henderson G. http://creativecommons.org/licenses/by-nc/3.0/. Disclaimer, National Library of Medicine Antihistamines used for the treatment of hay fever can be the cause of burning mouth. However, these conditions have not been consistently linked with the syndrome, and their treatment has had little impact on burning mouth symptoms. Treatment depends on symptoms and is aimed at controlling them. Patients with burning mouth syndrome often have high blood glucose levels, but no consistent or causal relationship has been documented.15 Nutritional deficiencies (vitamins B1, B2 and B6, zinc, etc.) The burning may progressively increase throughout the day, reaching its greatest intensity by late afternoon and into early evening.8 Patients often report that the pain interferes with their ability to fall asleep. The literature yielded clinical cases in which oral burning sensation is described after the administration of drugs belonging to different therapeutic groups: antiretrovirals, antiseizure drugs, hormones and particularly antihypertensive medication. A comprehensive medical examination will review whether any underlying diseases may be contributing to your symptoms. No related signs of disease are found in the mouth. Local factors associated with BMS include mucosal diseases, fungal infections, bacterial invasion, allergies, temporomandibular joint dysfunctions, and salivary gland abnormalities. Can nerve damage cause burning mouth syndrome? Burning mouth syndrome is described as either a primary or secondary type. But don't fret; your dentist/physician can evaluate you, take a thorough history, and review your symptoms to help establish a diagnosis. The burning sensation often occurs in more than one oral site, with the anterior two thirds of the tongue, the anterior hard palate and the mucosa of the lower lip most frequently involved.5 Facial skin is not usually affected. Are there certain medications that cause burning mouth syndrome? However, several medications have been reported to induce BMS. Burning Mouth Syndrome: Aetiopathogenesis and Principles of Management. Druginduced burning mouth syndrome: a new etiological diagnosis. If the peripheral sensitization continues for a long period of time, it adversely affects the central nervous system and results in neuroplasticity and central sensitization [14]. Cibirka RM, Nelson SK, Lefebvre CA. Would you like email updates of new search results? There are different factors:-. Medications linked to BMS include ACE inhibitors for hypertension, some antidepressants and high blood pressure medications, such as: Captopril. Each year, Mayo Clinic experts diagnose and treat more than 200 people who have burning mouth syndrome. Frequently-associated symptoms include dry mouth and loss or change of taste. In the course of managing her depression, the dosage of the drug fluoxetin was briefly increased one year prior to her visit from 100 to 200 mg per day for a month. In more than one half of patients with burning mouth syndrome, the onset of pain is spontaneous, with no identifiable precipitating factor. 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