If you are suffering from a burning or tingling sensation in your mouth that has no obvious cause, your doctor may diagnose you as having b...
If you are suffering from a burning or tingling sensation in your mouth that has no obvious cause, your doctor may diagnose you as having burning mouth syndrome. This is a relatively common problem. It affects more than one million people in the United States, mostly women of middle age and older. In fact, in postmenopausal women, the prevalence may be as high as 33 percent.
Current treatments for burning mouth syndrome focus on finding the reason that a person's mouth is burning so the source of the pain can be eliminated. For many people, mouth pain seems to be linked with affective disorders such as anxiety and depression, and treating those problems can be the fastest route to improving their symptoms. In other patients, burning mouth syndrome seems to be linked to medication side effects or food allergies, and looking at when symptoms started can give doctors a clue about how to make them go away. What if you're one of the many people whose burning mouth syndrome remains unexplained? Some scientists think nerve or circulatory problems may be causing your pain. But even without an explanation, there are still treatments available, such as clonazepam, that may help.
Find relief at last with the Your New Pain Prescription
Is It Burning Mouth Syndrome?
The one symptom all patients with burning mouth syndrome have in common is, as the name of the disorder implies, a burning sensation in their mouths. While most burning mouth syndrome symptoms occur on the tongue, they can also affect the lips and the palate. People's experience of the timing of burning mouth pain also varies; sometimes it's constant, sometimes it's intermittent, and sometimes it increases in severity throughout the day.
Burning mouth syndrome usually isn't diagnosed until you have experienced pain for several months. In part, this is because doctors primarily diagnose burning mouth syndrome by looking for underlying causes of your pain. If there's no good reason for your mouth to be burning, you may end up being diagnosed with the condition by default.
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That's why it's a good idea to keep a diary of your pain symptoms to discuss with your doctor or dentist. Be sure to record where the pain appears in your mouth, what times during the day you experience it, if anything improves your symptoms, and when the pain first appeared. The more information your doctor has about your burning mouth symptoms, the better chance she has of finding an effective way to treat them. In fact, if your pain is intermittent, you might even want to keep track of the food you eat and the medications you take to see if there is a correlation between the timing of your symptoms and something you're putting in your mouth. The Pain Diary in Part Three may help you zero in on the cause of your pain.
Fast Pain Relief
If you’ve been suffering from burning mouth syndrome for long enough to get a diagnosis, you know that there’s no quick fix for your pain. Still, there are a few tricks you can try that may reduce the toll that burning mouth syndrome takes on your mind and body.
1. Keep your mouth moist.
When your mouth is dry, the sensations of burning and pain can increase. Drinking water or sucking on a hard candy can help; but if dry mouth is a frequent problem for you, it’s worth asking your doctor to prescribe a lubricating solution.
2. Work on your oral habits.
If you tend to clench your teeth, chew on your lips, bite your tongue, or otherwise play with your mouth, make a real effort to stop. These activities can dry out your mouth and irritate or damage your skin, increasing your pain rather than making you feel better.
3. Find new ways to deal with depression and stress.
Anxiety, stress, and depression are closely linked to many people’s experiences with burning mouth pain, both because these conditions affect the way that sensations are processed in the brain and because people have reduced saliva production when they’re stressed.91 If you can improve your mental health through therapy, medication, or a combination of both, it may also have the pleasant side effect of relieving your physical pain.
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Your New Pain Prescription
The best thing you can do to relieve your burning mouth pain is to identify its underlying cause. Although your doctor is an excellent resource, there is also some research and experimentation you can do on your own.
Step 1:Try to figure out what’s causing your pain. Check your prescriptions in a Physicians’ Desk Reference to see if any of them has the side effect of mouth pain. See if your mouth is sensitive to the food you’re putting into it by selectively eliminating foods from your diet for 2 weeks. Eliminate mouthwash from your regimen since it can dry you out. Switch to a new toothpaste to make certain that it isn’t the source of irritation.
Step 2: Reduce your stress. Stress can make burning mouth pain worse, so finding ways to reduce your stress can also help you treat your pain. Whether this means taking time to go for a walk each day, adjusting your workload, or seeing a doctor for professional help, anxiety reduction can both reduce your pain and make it easier to cope with.
Step 3: Try supplementation. Experimenting with zinc supplementation is a relatively low-cost and low-risk technique for treating burning mouth at home. Zinc supplements are available over-the-counter and as a component of multivitamins. Just don’t take more than the recommended dose.
Pain Prevention Strategies
Food and Supplements
Zinc
Zinc is the second most abundant mineral in the body after iron. Several studies have suggested that zinc deficiency may play a role in burning mouth syndrome for a subset of patients.
The evidence: A study of 276 patients with burning mouth syndrome found that approximately 25 percent of them had low blood zinc levels. When they were treated with 14.1 milligrams a day of zinc and a steroid gargle, 72 percent of the patients experienced partial or complete pain relief compared to 52 percent of the controls, who received only the gargle.
How it works: Zinc plays a role in the function of the nervous, immune, and reproductive systems. It is also associated with good mental health. In people with zinc deficiency, dietary supplementation can help raise levels to normal and improve overall health. Zinc may also improve taste perception, which is a problem common in individuals with burning mouth syndrome.
What you need to know: Follow-up studies are definitely indicated to see how well zinc replacement works in larger populations of individuals with burning mouth syndrome, including those who are not noticeably zinc deficient. However, adding a zinc-containing multivitamin to your diet if you are not already taking one poses minimal risk to your health as long as you stay below the tolerable upper limit, which for adults is 40 milligrams a day.
Capsaicin
Capsaicin is the substance that makes hot peppers burn your mouth. That’s why it’s slightly ironic that it may also be an effective treatment for burning mouth syndrome.
The evidence: A small, placebo-controlled trial involving 50 patients with burning mouth syndrome found that swallowing capsaicin caplets significantly reduced mouth pain. Another small study of 14 patients found that a thrice daily mouth rinse with 250 milligrams of red pepper emulsion in 50 milliliters of water could also be effective.
How it works: Capsaicin causes a burning sensation in the mouth, but that sensation can desensitize the nerves of the mouth to pain by overloading their response cycle.
What you need to know: Capsaicin pills can cause serious stomach upset when used too often. Although topical capsaicin treatments such as “hot” candies and Tabasco sauce have been shown to be useful for the treatment of other oral pain syndromes, there have been few studies of their efficacy in treating burning mouth.
Mind-Body Therapies
Psychotherapy
There is some evidence that certain types of oral habits—including pressing the tongue against the teeth, clenching or grinding the teeth, and biting the tongue or lips—may predispose individuals to burning mouth syndrome. In addition, burning mouth syndrome has been linked to anxiety, depression, and other affective disorders.
The evidence: A study comparing group psychotherapy to the use of a placebo pill found that pain scores improved in 70 percent of the patients in the psychotherapy group but only 40 percent of patients in the placebo group.
How it works: Different types of psychotherapy can be a useful way not only of adjusting problematic habits but also of improving people’s ability to deal with their pain. In addition, since burning mouth syndrome is linked to affective disorders such as anxiety and depression, for many patients treating those disorders may also improve symptoms by eliminating their underlying cause.
What you need to know: Both individualized cognitive-behavioral therapy and group psychotherapy have been shown to improve the pain that people experience from burning mouth syndrome. It may, however, take several months for therapy to have an effect.
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Pain Medications and Medical Treatments
Clonazepam
Clonazepam (Klonopin) is an antiseizure drug that is also used for the treatment of panic attacks. It is one of a class of medications known as benzodiazepines.
The evidence: A randomized controlled trial of 48 patients with burning mouth syndrome found that sucking on a 1-milligram tablet of clonazepam reduced pain scores by four times as much as sucking on a placebo tablet.
How it works: It is thought that clonazepam might reduce burning mouth syndrome pain by altering the reactivity of GABA nerve receptors in the mouth; however, its mechanism of action is still poorly understood.
What you need to know: Clonazepam is probably the most widely accepted medical treatment for burning mouth syndrome; however, it can also cause burning mouth syndrome when used in some patients. In addition, there is a risk that clonazepam can be habit forming with prolonged use, which means that it should not necessarily be your first choice for treatment.
Other Strategies
Watch what you put in your mouth: Sometimes burning mouth syndrome is caused by underlying health problems, but other times it seems that the pain is caused by the things that go into your mouth.
The evidence: Although allergy does not seem to be responsible for most cases of burning mouth syndrome, it may play a role in some people’s pain. In addition, some foods and products may cause irritation without an allergic reaction. Therefore, changing your diet and the oral care products you use may be an effective way to deal with your pain.
How it works: Low-level allergies and contact hypersensitivity can make your mouth feel like it’s starting to burn. Figuring out what products irritate your mouth and keeping them far away is a good way to stop your pain and keep it from coming back.
What you need to know: The American Dental Association recommends that people with burning mouth syndrome try eliminating gum, tobacco, and acidic foods (soft drinks, coffee, some fruit juices) from their diets for at least 2 weeks to see if their symptoms improve. It also suggests removing mouthwash entirely from your oral care routine, since it can dry out your mouth, and switching toothpaste brands in case additives are responsible for your symptoms.
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