Burning mouth syndrome

What is it about ?

Burning mouth syndrome is a burning sensation in the lining of the mouth or tongue. It is often accompanied by pain in the tongue.

The causes

The cause is unclear. Local and general factors may play a role, as can psychiatric disorders:

• local factors :
  • dental problems, such as tartar, cavities, problems due to dentures, allergy to dentistry materials;
  • jaw abnormalities where the upper and lower teeth do not join together well;
  • tumors of the mouth;
  • infections with viruses or fungi (canker sores);
  • eating habits: food that is too hot or too spicy;
  • smoking;
  • excessive alcohol consumption;
  • side effects of drugs;
  • excessive use of mouthwashes;
  • dry mouth, mouth breathing, certain medications, salivary gland problems, pregnancy or menopause.
• general factors : Burning mouth syndrome can be a symptom of another condition (this condition is said to be underlying), such as:
  • diabetes ;
  • Sjögren’s disease ;
  • a deficiency in iron or vitamin B12;
  • blood diseases, such as anemia or leukemia;
  • skin diseases, such as lichen planus ;
  • neurological damage, such as neuralgia or multiple sclerosis (MS).
• psychiatric factors : Mental disorders such as depression, anxiety and psychosis can be accompanied by burning mouth and pain in the face.

What is its frequency?

Oral symptoms occur mainly in adults between the ages of 40 and 70 and are five times more common in middle-aged women.

One in two people who wear dentures suffers from oral infections.

How to recognize it?

The main symptoms are :

• burning sensation or pain in the mouth and tongue;
• dry mouth;
• complaints about dentures;
• taste disturbances.

These symptoms are most marked in the evening and are dependent on the cause of the pain :

• In smokers, there are sometimes small red dots in the mouth (from inflammation of the small salivary glands) and a red stripe-shaped area in the middle of the tongue.
• Excessive use of mouthwash irritates the oral mucosa. This is manifested by small red spots in the mouth, which change places every day.
• A dry mouth is caused by too little saliva. The tongue becomes dry and looks leathery.
• Teeth may have excessive tartar or cavities.
• In the event of inflammation due to the prostheses, you suffer from redness and pain of the oral mucosa under the prosthesis. It is usually accompanied by a fungal infection (fungal infection) with white patches on the gums. Sometimes the corners of the lips are also affected.
• Pain on only one side and in a specific location, especially on the side of the tongue, may be a sign of an early malignancy.

If another disease is causing these complaints, you also have symptoms of that other disease.

How is the diagnosis made?

Discussion

The doctor will first ask you questions about your lifestyle (smoking, consumption of spicy foods, consumption of alcohol and mouthwash, presence of dentures, pre-existing diseases and taking medication).

Exams

• Then he will examine mouth, tongue, teeth and throat. Often this is enough to make the diagnosis.
• Sometimes it is necessary to have a blood test to find an underlying cause.
• If a tumor is suspected, a biopsy lesions. A biopsy is the removal of a small piece of tissue for examination in the laboratory.

What can you do ?

Adopt a healthy lifestyle :

• Stop smoking.
• Moderate your alcohol consumption.
• Avoid stress.
• If necessary, adapt your diet: avoid consuming very hot or very spicy food.
• Have your teeth checked in time and use sodium lauryl sulfate-free toothpaste.

Often the symptoms of burning mouth syndrome go away on their own, but sometimes they persist for several years.

What can your doctor do?

The doctor will look for an underlying cause.

• If you lack iron or vitamins, supplements may be helpful.
• Sometimes the doctor will advise you to go to the dentist to change your dental prosthesis.
• The abnormalities of the bone under the gums (alveolar arch) sometimes require surgery by the dental surgeon.
• In case of suspicion of tumor, the doctor refers the patient to a specialist.
• Existing diseases that may be associated with burning mouth syndrome will be investigated.
• In some cases, a psychiatric assessment may be indicated.

Want to know more?

• Mouth and teeth (images) – Christian Mutuality
• Tips for unparalleled oral hygiene – Christian Mutuality
• Visiting your dentist – Christian Mutuality
• Dental health professionals – Christian Mutuality

• Stop smoking. It’s possible – Tabacstop
• Alcohol, the point on your consumption – Stop or else?

Source

Foreign clinical practice guide ‘Burning mouth syndrome and glossodynia’ (2000), updated on 07.09.2016 and adapted to the Belgian context on 01.07.2017 – ebpracticenet