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Burning mouth syndrome is a condition of searing pain in the mouth that seems to come on for no reason at all. It can affect just the tongue, usually the front 2/3 of the tongue. It may or may not extend to the lips and the lining of the mouth. It may come and go through the day, or last all day, usually becoming worst in the early evening. There can also be Xerostomia, dry mouth, in this condition. The salivary glands continue to function but aren't stimulated by the nerves that tell them when to release fluid. Most doctors aren't very familiar with the problem, which may also be known as stomatopyrosis, stomatodynia, glossopyrosis, glossodynia, sore mouth, sore tongue, or oral dysesthesia.

No Visible Symptoms

There aren't any obvious changes to the tissues of the tongue or mouth in burning mouth syndrome, and there usually isn't any clear precipitating event in burning mouth syndrome, either. It just shows up. It can be either triggered or relieved by eating and drinking. After people have had it for four to six months, they tend to experience personality changes. Since burning mouth syndrome is a diagnosis of exclusion, different people may have different sets of symptoms but be diagnose with the disease.

Is Burning Mouth Syndrome All in Your Mind?

Doctors used to think that burning mouth syndrome was of psychological origin. There is evidence that anxiety and depression are associated with the problem, but that doesn't reveal whether anxiety and depression cause burning mouth syndrome or burning mouth syndrome causes anxiety and depression. 

Researchers now believe that burning mouth syndrome is neurological in origin. Sensory nerves in the tongue become unbalanced. The fibers for taste perception don't work as well as they should. People who have the condition can taste metallic and sour tastes better than sweet, salty, or umami. The fibers for pain perception, on the other hand, work too well. They become overactive.

Burning mouth syndrome isn't a mental illness, but the way nerves are affected in the tongue is similar to the way neurons in the brain are affected during a hallucination or tinnitus. The unilateral chorda tympani (taste) nerve becomes under-functioning and the lingual (pain) nerve becomes hyperactive. The result is searing pain without an external cause. It would be technically correct but misleading to call this a hallucination. You aren't crazy if this happens to you. You just have some peripheral nerves that are seriously out of order.

Who Gets Burning Mouth Syndrome?

Burning mouth is more common in women than men by about seven to one. It's very rare before the age of 30. It tends to occur in people who have other gastrointestinal problems or urogenital disease, although doctors don't know what the connection might be.

What Can Be Done About Burning Mouth Syndrome?

It may be little comfort to know that about 3 percent of people who have burning mouth syndrome go into spontaneous remission, and up to 2/3 improve even without treatment after six to seven years. That's a long time to deal with the pain. 

Medical treatments for burning mouth syndrome include:

  • A selective serotonin reuptake inhibitor (SSRI), more often used to treat depression.
  • Older-style antidepressants such as amitriptyline (Elavil), still used to treat neuropathy.
  • Clonazepam tranquilizers (taken as a soluble wafer you hold on your tongue rather than as a pill).
  • Laser therapy to "zap" the lingual nerve.
  • Adjustment of thyroid hormone levels.
  • Medically supervised acupuncture to increase blood flow to the tongue and "rebalance" the nerves.

If you couldn't get any treatment at all, the best thing to do would be, oddly enough, to start including hot peppers in your food. The burn caused by the capsaicin in hot peppers "distracts" your lingual nerve so that it doesn't generate as much pain. This may also work with medical treatment.

It can also help to chew sorbitol-sweetened chewing gum. The sorbitol may calm the digestive problems that are associated with burning mouth and relieve the burning. It will also stimulate salivation and reduce dry mouth.

Alpha-lipoic acid supplements, which are also used in diabetic neuropathy, may relieve nerve pain.

Generally, anything you do for good oral hygiene also relieves burning mouth syndrome. Keeping your mouth moist and fresh, making sure dentures fit, and avoiding tobacco or marijuana smoke all help.

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