BURNING MOUTH SYNDROME (BMS)

by Drthomasrector 18. January 2010 02:53

BURNING MOUTH SYNDROME (BMS)
by Thomas C Rector DDS Muncie In Family Dentist

 Many of my patients ask me about the burning they have in their mouth.  It is sometimes an extremely painful and chronic condition for which no medical or dental cause can be found.  We frequently go through the process of excluding all other possibilities of the pain source before arriving at a diagnosis.  Often these patients experience anxiety, depression, and frustration, which is completely understandable.

BMS is commonly asociated with xerostomia,(dry mouth). Statistics show BMS to be approximately 33 times more common in women than in men and usually appear during or after menopause.  The most common cause of BMS is local irritation, such as, cigarette smoke or certain foods that are high in citric content.  The second-most common cause is candidiasis. Many side effects of the physician prescribed medications are a common source of BMS. Often, the early onset of the common cold or other associated viral infections may lead to BMS.  Another, sometimes overlooked, cause is vitamin B12 deficiency.  New research has found a chain of events leading to BMS can be initiated at menopause by a drastic drop in the levels of certain steroids. This leads to neurodegenerative alterations of small nerve fibers of the oral mucosa and/or some brain areas involved in oral somatic sensations. The changes then become irreversible and cause the symptoms of BMS. This would explain why women are more susceptible to this condition. Wonderful, who ever coined the phrase "The Golden Years" was probably only 25.

Whatever the cause, once we have arrived at the diagnosis of BMS, the first step in managing it is to eliminate all potential local and systemic factors that may have led to the disorder. This includes smoking and medication, if feasible. It is of paramount importance to reassure my patients that his or her search for a cause and a cure is over.

"I frequently tell my patients, no, it's not all in your head, and no, you don't have cancer and you're not going to die." The next step involves treating the symptoms. Some evidence does indicates that both tricyclic amines and selective serotonin reuptake inhibitors can control the pain associated with BMS. However, antidepressant use can prompt its own significant side effects, including sleepiness, dizziness, and cardiac concern.

Cognitive behavioral therapy has also been shown in both anecdotal and experimental reports to reduce symptoms of BMS, particularly when combined with medication.  Often patients can be referred to a psychologist for this form of therapy. The primary goal is to teach patients not to focus on their symptoms. Alpha-lipoic acid can also be effective for reducing BMS symptoms. It is used at a dosage of 300 mg twice a day for three weeks, followed by 300 mg once a day. Alpha lipoic acid is a fatty acid found naturally inside every cell in the body. It's needed by the body to produce the energy for our body's normal functions. Alpha lipoic acid converts glucose (blood sugar) into energy. Alpha lipoic acid is made by the body and can be found in very small amounts in foods such as spinach, broccoli, peas, Brewer's yeast, brussel sprouts, rice bran, and organ meats. You can buy alpha lipoic acid at any health food store.

In conclusion, many of you may have experienced signs and symptoms of Burning Mouth Syndrome in your lifetime.  Thankfully, it usually is gone as quickly as it arrived.  But, for those unfortunate few, don't be discouraged, BMS is not a disease.  You cannot pass it on to your loved ones. It is condition that may be a direct result of our "modern medicine" itself.  More research is being done daily, I will keep everyone informed.

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