Burning Mouth Syndrome -- Causes and
Cures
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March 20, 2010, Last Updated July 27, 2013

By Susan M. Callahan, Associate Editor and Featured Columnist
[Health and fitness articles are reviewed by our team of Registered
Nurses, Certified fitness trainers and other members of our Editorial
Board]



Ever drink a scalding cup of coffee?  Remember the intense
pain. Your mouth literally feels like it’s on fire. And it take
can days for your mouth and tongue to feel normal again.  
Imagine, then, what it would feel like to wake up in the
morning—every morning—with the feeling that you had just
scalded your mouth.  Or imagine, waking up feeling normal
but then, for no reason at all, the burning in your mouth
starts, seemingly from nowhere, and gets more and more
intense as the day goes on.  

It's called "burning mouth syndrome".  According to most
sources, between 1 and 4 million Americans suffer from
this painful malady. The University of Texas Health Center
at Houston estimates that 3% of all Americans and 14% of
all post-menopausal women experience burning mouth
syndrome.

Burning mouth syndrome affects 7 times more women than
men.  The condition occurs most often in women after
menopause but can occur at any age and affect both men
and women.

Burning mouth syndrome is known by various other
names, including stomatopyrosis, stomatodynia, scalding
mouth syndrome, or when it affects the tongue, burning
tongue,  glossopyrosis or  glossodynia. When it only affects
the lips, it’s known as "burning lips syndrome".

There Are 3 Different Types of Burning Mouth Syndrome

























According to a study led by Dr. Katharine Meddles of the
University of Colorado School of Medicine, burning mouth
syndrome may also be classified into 3 types, varying by
the type of symptoms:

•        Type 1 burning mouth syndrome (BMS):  In this
type, you have no symptoms upon waking, but the pain
gets progressively worse throughout the day. You may or
may not experience nighttime symptoms .  This type of
burning mouth syndrome may be caused by one or more
nutritional deficiencies or
diabetes.

•        Type 2 burning mouth syndrome (BMS): In Type 2
burning mouth syndrome, you feel burning continuously
throughout the day but usually no symptoms at all at
night.  Type 2 burning mouth syndrome has been linked to
chronic anxiety.

•        Type 3 burning mouth syndrome (BMS): In Type 3
burning mouth syndrome, you have on-and-off,
intermittent symptoms throughout the day. You also
experience days where you have no symptoms at all. Food
allergies are the most likely cause of Type 3 burning mouth
syndrome.


What Causes Burning Mouth Syndrome?

Burning mouth syndrome always involves injury to or
malfunction of nerves in the mouth. It’s the damage to the
nerves in your mouth that causes the burning pain.
However, the exact cause of the damage to the nerves ---
which then leads to burning mouth syndrome--- is not
known in many cases. In these cases, the syndrome is
called primary or "idiopathic".  When a cause or condition
which caused the burning can be identified, it is called
"secondary burning mouth syndrome".

There are many known causes of secondary burning mouth
syndrome. Here is the list 20 known causes of burning
mouth syndrome, drawn from university or hospital
research studies.

1.
Vitamin B Deficiencies. Deficiencies in Vitamin B-1
(thiamin), Vitamin B-2 (riboflavin), Vitamin B-6
(pyridoxine) and Vitamin B-12 (cobalamin) are common
causes of burning mouth syndrome. These B vitamins are
essential to the health of your nerves.

2.
Anemia. Lack of iron (common anemia) or vitamin B-12
(
pernicious anemia) can cause burning mouth syndrome.
3. Zinc Deficiencies. Zinc is an overlooked but essential
mineral found in oysters and other foods. Zinc is also
commonly included in multi-vitamins.

4.
Vitamin D Deficiencies. Little known in the literature on
burning mouth syndrome, Vitamin D has been identified as
a possible remedy for nerve pain in several studies on the
treatment of nerve damage (neuropathy) caused by
diabetes. Although studies using Vitamin D specifically for
treatment for burning mouth syndrome are not complete,
expectations are that Vitamin D is likely to help with nerve
damage related to burning mouth syndrome as well.

A 2008 study lead by Drs. Paul Lee  Roger Chen from the
Concord General Repatriation Hospital in Australia, and
published in the Archives of Internal Medicine, found that
“, vitamin D insufficiency is underrecognized and may be a
significant contributor to neuropathic pain in type 2
diabetes. Vitamin D supplementation may be an effective
"analgesic" in relieving neuropathic pain. “

What should you do? At this point, given the fact that
Vitamin D has no known toxicity, you should make sure
that you are taking adequate amounts of Vitamin D ---
specifically Vitamin D3 --- if you have burning mouth
syndrome. (Can you get too much Vitamin D? Read more
about
Vitamin D overdose.)

5.
Thyroid Conditions. A 2006 study from researchers at
the University of Medicine and Surgery in Napoli, Italy,
found that  thyroid conditions may be responsible for
burning mouth syndrome in many women.

The study examined 50 patients with burning mouth
syndrome and found that 5 had hyperthyroidism (over-
active thyroids), 4 had higher than normal levels of thyroid
anti-bodies and 34 out of the remaining 41 (83%) showed
some abnormality in thyroid nodal activity.

6.
Deficiencies in Alpha Lipoic Acid. Alpha lipoic acid
(known also as thioctic acid or LA) is one of the essential
fatty acids used by every cell in your body.

Like Vitamin C and E, alpha lipoic acid is an antioxidant,
capable of neutralizing free radicals which cause oxidative
damage to your cells.  Oxidative damage can cause pain
and aging of cells. Unlike Vitamin C and E, lipoic acid is
soluble in both fat and water.  For this reason, alpha lipoic
acid can cross all cell barriers and enter into every cell in
your body to reduce oxidative free radicals.

Alpha lipoic acid is found in small amounts of foods such as
spinach, brussel sprouts, broccoli and peas, and in  
supplements including brewer’s yeast. Alpha lipoic acid is
also sold as standalone supplements in many health food
stores.

Alpha lipoic acid has become the most popular remedy for
burning mouth syndrome. Several heralded studies have
confirmed the effectiveness of LA for treatment of burning
mouth syndrome. The theory behind the effectiveness of
alpha lipoic acid is that burning mouth syndrome is caused
by the release of toxic free radicals during stressful
situations.

A 2002 study from the University of Medicine and Surgery
at Napoli Italy examined 60 patients with constant burning
mouth syndrome. After 2 months of treatment with alpha
of lipoic acid, the majority of patients showed significant
improvement. Over 70% of the patients maintained the
improvements even after a year of follow-up study.

Keep this in mind, however. This study has been
contradicted by other studies which found that alpha lipoic
acid supplementation is no more effective than a placebo in
treating burning mouth syndrome.

7.
Dry Mouth. Dry mouth or related conditions such as
Sjogren's syndrome has many causes, including
dehydration and certain medications. If you find that, in
addition to the burning that you are also experiencing dry
mouth, you can find commonly
recommended remedies for
dry mouth here.

8. Being a “Supertaster”. Some people are born with more
than the normal number of taste buds on their tongues,
making them more susceptible to burning mouth or burning
tongue syndrome. Supertasters can sometimes have double
or triple the normal number of taste buds.

According to the Yale University School of Medicine Taste
Laboratory, a drug called clonazepam may be effective. Dr.
Miriam Grushka discovered that Clonazepam (Klonopin)
treats burning mouth pain in about 70% of patients
(Grushka, Epstein & Mott, 1998). Dr. Grushka's research
suggests a starting dosage of 0.25 mg per day. If this is
ineffective after one week, she usually recommends  
increasing the dosage to 0.50 mg per day. If after another
week, the symptoms still do not decrease, she recommends
an increase to 0.75 mg per day is suggested.  

A word of caution.  Higher doses are usually ineffective and
may produce unwanted side effects including drowsiness.
In these cases, small doses (e.g., 50 to 300 mg per day) of
another drug called gabapentin may be helpful. Remember,
clonazepam and gabapentin, like all prescription drugs,
should only be used under the direction and care of a
physician.

9.
Thrush. Yeast infections can cause burning mouth
syndromes. Eating yogurt or other
foods that help thrush
can help relieve burning mouth syndrome in such cases.

10.
Acid Reflux or GERD. Acid reflux can cause the acids of
the stomach to flush back high into the throat and mouth,
resulting in burning mouth syndrome. Here are some
common remedies for acid reflux or GERD.

11.
Depression.  New research has identified foods that
help to relieve mild depression, a suspected cause of some
cases of burning mouth syndrome.

12.
Excessive Worry or Stress. Excessive worry has been
linked to increased risk of many diseases and conditions,
including burning mouth syndrome and high blood
pressure.

13.
Ill-fitting Dentures or Dental procedures. After dental
procedures, some people are left with a metallic taste in
their mouth. Later on, the metallic taste may be followed by
burning mouth syndrome.


14.
Allergies.

15.
Brushing Your Tongue Too Hard.

16. Upper Respiratory Infections.

17. Teeth-grinding or teeth thrusting.

18. Menopausal hormone changes. Women after
menopause are more likely to suffer from burning mouth
syndrome, with one 1989 study from the University of
Melbourne in Australia estimating that as many as 18% of
women  suffering from the condition. The same study
found that as many as 76% of such women can be helped
by taking alphalipoic acid as a dietary supplement. Certain
foods also contain low yeast,Brussels sprouts
, tomatoes,
rice bran, carrots, and beets.

19.
Foods Can Cause Burning Mouth Syndrome. Eating
acidic foods such as citrus fruits (oranges, lemons, kiwis,
etc) can cause burning mouth syndrome.

20.
High Blood Pressure Medications.  Blood pressure
medications can cause burning mouth syndrome. If your
doctor agrees, you might try adding
foods that reduce
blood pressure to your diet, in an effort to slowly decrease
the amount of medications you have to take.



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