Burning mouth syndrome

Diagnosis

Diagnosing burning mouth syndrome involves a process of elimination, involving the exclusion of other conditions with similar symptoms, such as oral yeast infections like thrush. There is no single definitive test for BMS.

The diagnosis often involves review of medical history and medications, examination of the mouth, and assessment of symptoms, oral hygiene habits, and routines. Seeking initial consultation with a dentist is recommended for those experiencing symptoms, as one-third of BMS cases are attributed to oral health issues.

A medical examination is likely to be conducted to identify signs of other underlying conditions. Necessary tests include:

• Blood tests: The findings of the test may provide information on what’s causing mouth pain. The immune system’s function, thyroid function, blood sugar level, nutritional status, and full blood count can all be assessed with these tests.
• Allergy tests: Allergies to specific foods, additives, or even materials used in dental procedures or oral care products is identified during this test.
• Salivary flow test: Due to the sensation of dryness associated with burning mouth syndrome, tests measuring salivary flow can indicate if there is a reduction in saliva production.
• Oral cultures or biopsies: During a biopsy, small bits of tissue are removed from the mouth for laboratory analysis. For oral culture, a sample is collected from the mouth using a cotton swab. This can determine whether the oral cavity is infected with bacteria, viruses, or fungi.
• Gastric reflux tests: Regurgitation of stomach acid into the mouth is detected through this test.
• Imaging:  To investigate potential underlying health issues, imaging procedures such as a magnetic resonance imaging (MRI) or computed tomography (CT) scan may be suggested.
• Modification of prescribed drugs: Adjusting the dosage, switching to another medicine, or temporarily stopping the medication may be recommended in cases where the medication causes mouth discomfort.
• Mental health questions: Symptoms indicative of depression, anxiety, or other mental health conditions that could be connected to burning mouth syndrome may require further assessment through a designed questionnaire.

Treatment

Primary Burning Mouth Syndrome

There is currently no known cure for primary burning mouth syndrome, and effective treatment methods vary. Due to limited research, finding the most suitable approach may require experimentation. Managing symptoms is the primary goal, and it may take time to identify a successful treatment or combination.

Treatment options:

• Saliva replacement products: To alleviate dry mouth symptoms.
• Specific oral rinses or lidocaine: Providing numbness for pain relief.
• Capsaicin: A pain reliever derived from chili peppers.
• Alpha-Lipoic Acid: An antioxidant that may help relieve nerve pain.
• Clonazepam (klonopin): A medication used to control seizures.
• Antidepressants: Specifically chosen based on symptoms.
• Medications blocking nerve pain: Targeting pain receptors.
• Cognitive behavioral therapy (CBT): Developing practical skills to address anxiety, depression, stress, and pain management.

Secondary Burning Mouth Syndrome

For secondary burning mouth syndrome, treatment hinges on addressing underlying conditions contributing to mouth discomfort.

• Identify the cause: Determine and address the root cause, such as oral infections or vitamin deficiencies.
• Treatment of underlying conditions: Administer appropriate treatments, such as antibiotics for infections or supplements for nutritional deficiencies.
• Symptom relief: Alleviate burning mouth syndrome symptoms by resolving the underlying issues.

Understanding the specific type and cause of burning mouth syndrome is crucial in tailoring an effective treatment plan. Once underlying causes are treated, improvements in burning mouth syndrome symptoms are expected.