Burning Mouth Syndrome

Our focus at DesertSmiles is providing the finest in Phoenix cosmetic dentistry but we always first are conscious of the overall health of all of our patients.  In the rare instance that you may be suffering from Burning Mouth Syndrome we hope you will find this information of value.

Burning Mouth Syndrome (BMS) is one of those conditions that we do not know the cause of mechanism.  Burning Mouth is often accompanied by dry mouth and thirst, altered taste (dysgeusia) and other pain complaints.  Pain and taste are mediated by small nerve fibers, while salivary flow is controlled by the sympathethic and parasympatheric nervous systems, the linkage is unclear.  Previous beliefs that a lack of B vitamins or iron have not been shown to be linked.

BMS patients report a persistently altered (metallic) taste or diminished taste sensations.  Acidic foods such as tomatoes and orange juice cause considerable distress.  Most of the common laboratory tests suggested for BMS patients will be negative as well.

Part of the differential diagnosis is the use of topical anesthetic rinses.  If the pain decreases, then look for local factors such as denture trauma, GERD, vitamin deficiencies, etc..  If the pain increases, then we are looking at neuropathic pain or even Sjogren’s Syndrome.  The patient should be checked for Sjogren’s.

The presence of BMS is very uncommon before the age of 30; 40 years for men.  The onset in women usually occurs within three to 12 years after menopause, and is higher in women who have systemic disease.

Treatment of BMS has traditionally been use of Tricyclic antidepressants such as Elevil or Pamelor.  More recently clonazepam (Klonopin) has had much success.  There is no standard dosing to this.  Start with a low dose and gradually increase until an effective dose is titrated.

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