Burning Mouth Syndrome (BMS)

Burning Mouth Syndrome is a neuropathic pain, a dysfunction of the sensory nerve pathways that supply the mouth.  The dentist treats BMS symptomatically. The oral cavity shows no signs of tissue changes. Diagnosis of Burning Mouth Syndrome is by ruling out other mouth burning sensations that have a specific treatment. The discomfort and irritability associated with Burning mouth syndrome may cause mood changes, depression, and anxiety in some patients.

The majority of mouth burning symptoms are not neuropathic but are due to mucous membrane abnormalities from many potential suspects:

• Mouth burning sensation from mechanical irritation due to ill-fitting denture
• Dry mouth
• Allergy to dental materials
• Toothpaste or other environment allergens
• Infection
• Thermal injury (burn)
• Auto-immune disease

The symptoms:

• Burning sensation or scalding pain in the mouth including the lips in moderate to severe. 
• Dry mouth
• Some patients experience metallic taste or bitter taste
• Pain is gradually intensifying

Causes of the Burning mouth syndrome are unclear and difficult to diagnose.  There may be more than one cause attributed to Burning Mouth Syndrome.

Treatment: Burning Mouth Syndrome treatment varies. Moreover can only be treated symptomatically. The most significant treatment decision lay upon the proper diagnosis of the true Burning Mouth Syndrome by distinguishing true Burning Mouth Syndrome from other mouth burning conditions.  For an accurate diagnosis of Burning-Mouth-Syndrome, consults with an oral & maxillofacial pathologist in your area.

The medication most frequently prescribed is Clonazepam (in tablet or liquid mouthwash form).

Dry Mouth

Dry mouth (Xerostomia) is a condition resulting from decreased or ceased production of saliva. The saliva becomes thick, and oral mucosa membrane becomes irritated, rough and red.  There will be the onset of soreness and candidiasis in a chronic case.

Symptoms of dry mouth include:

• Dry feeling inside the mouth (tongue, throat)
• Difficulty chewing, speaking, tasting, and swallowing
• Redness of mucous membrane
• Increase dental caries
• Onset of Infection and candidiasis in a chronic case

Saliva functionality:

• The enzymes in saliva help digest food
• Prevent cavity by removing food particles from the teeth
• Improve taste
• Tissue lubrication
• Makes it easy to chew and swallow
• Prevent bad breath
• Help retain full dentures
• Reduces the acidity produced by waste products, protect the enamel from being damaged by high acidity

Causes of dry mouth

1. Side effect from medications - both prescription and nonprescription drugs include antihistamine, hypertension, allergy, anxiety, depression, and pain medications are the most common cause of dry mouth
2. Radiation therapy or chemotherapy to the head and neck area
3. Autoimmune disorder such as Sjögren's syndrome, systemic lupus erythematosus
4. Salivary gland disease or salivary gland disorder 
5. Obstruction of salivary ducts
6. Nerve damage at the head and neck area
7. Dehydration due to fever, diarrhea, loss of blood, vomiting, burns
8. Absent of salivary glands or damaged salivary glands
9. Mouth breathing
10. Poorly control diabetes, HIV/Aids 
11. Use of tobacco products will aggravate dry mouth
12. Use of alcohol, caffeine

 Management of dry mouth:

• Use artificial saliva substitutes, e.g., Oasis Moisturizing Mouthwash or Biotene Oral Rinse. These products do not increase saliva flow, but will lubricate the tissue and reduce irritation from dry mouth
  
• Use saliva stimulant medications to increase saliva flow, e.g., Pilocarpine, Cevimeline
• Chew sugarless gum with xylitol, e.g., Xlear Spry Gum to stimulate saliva flow
• Avoid using an irritant mouthwash that contains alcohol, hydrogen peroxide
• Avoid using toothpaste that contain sodium lauryl sulfate, use Epic Dental Xylitol Toothpaste instead
• If your medications cause dry mouth, consult your physician before altering or reducing the dosage of your medications
• Stop using tobacco products
• Evaluate upper respiratory tract for problems that may predispose to mouth breathing
• Have full diagnostic assessment by physicians for other systemic diseases that may contribute to dry mouth

Note: Dry mouth and Burning Mouth Syndrome may have some similarities in symptoms, but the causes and treatment of dry mouth are different from Burning Mouth Syndrome.