Burning Mouth Syndrome, Glossodynia

Diagnosis

The diagnosis of burning mouth syndrome can be challenging because involves the elimination of other potential causes like oral yeast infections. It is recommended to consult with a dentist initially, as oral health issues contribute to a significant portion of BMS cases. Generally, no single test can diagnose BMS.

The diagnosis involves a comprehensive approach which typically includes a thorough review of the individual’s medical history and medications, a physical examination of the mouth, a discussion about the symptoms experienced, an exploration of oral hygiene habits and routines, and some tests.

Tests that may be required include:

• Blood tests: The findings of this test may provide information on what is causing mouth pain. The immune system function, thyroid function, blood sugar level, nutritional status, and full blood count can all be assessed during a blood test.
• Salivary flow test: This test can detect if the flow of saliva is decreased. Dry mouth can be an indicator of burning mouth disease.
• Oral swab test or tissue biopsies: Small pieces of tissue are removed from the mouth, usually using a cotton swab, for laboratory analysis. This can determine whether the oral cavity is infected with bacteria, viruses, or fungi.
• Imaging tests: To check for additional health issues, an MRI, CT scan, or other imaging tests.
• Allergy tests: To find out if a person might be allergic to any foods, additives, dental materials, or mouthwashes, allergy testing may be advised.
• Tests for acid reflux: If stomach acid leaks from the stomach back into the mouth, these tests can detect it.
• Adjustments in medication: Stopping the medicine temporarily may be considered. Changing the dose or switching to a different one may also be necessary. However, this requires supervision from a healthcare provider as discontinuing certain medications can be risky.
• Mental health assessment: Symptoms of depression, anxiety, or other mental health conditions associated with burning mouth syndrome may be assessed through mental health questions.

Treatment

The treatment for burning mouth syndrome typically involves medications. Although no medication is made specifically for BMS, other medications can alleviate the symptoms.

• Primary burning mouth syndrome: The treatment focuses on symptom control, and individuals may need to experiment with various options before finding a suitable combination. Treatments for primary BMS include saliva replacement products, specific antidepressants, and cognitive-behavioral therapy to address anxiety, depression, stress, and cope with persistent pain.
  Other medications may be recommended, such as:
  • Medications targeting nerve pain
  • Alpha-lipoic acid as a nerve pain reliever
  • Capsaicin for pain relief
  • Clonazepam for seizure control

Primary burning mouth syndrome lacks a known cure, and effective treatment methods are not firmly established due to limited research. Managing symptoms may require time, and individual responses to treatments can vary.

• Secondary burning mouth syndrome: If issues like teeth grinding or jaw clenching are the cause of burning mouth syndrome, a dentist can assist in correcting these oral problems. If it is due to issues like an oral infection or a deficiency in certain vitamins, treating these specific causes can improve the condition. Generally, if an underlying health condition is identified as the trigger for BMS, addressing and treating that specific condition is likely to lead to the alleviation of burning mouth symptoms.