From the Guidelines
Burning mouth syndrome primarily involves a burning sensation in the mouth, but it can also include other symptoms such as dry mouth, increased thirst, taste changes, and loss of taste, and while it doesn't directly cause cognitive issues, the chronic pain and discomfort can lead to secondary problems like difficulty sleeping, irritability, anxiety, and depression, which may affect cognitive function. The main symptoms are a burning or scalding feeling that may affect the tongue, lips, gums, palate, throat, or the entire mouth, often described as similar to a hot drink burn 1. Additional symptoms include tingling or numbness in the mouth or tip of the tongue. The condition often occurs without visible abnormalities in the mouth and may develop suddenly or gradually. The exact cause is often unclear but may involve nerve damage, hormonal changes, dry mouth, allergies, or psychological factors, and it is more common in women, particularly after menopause, suggesting hormonal influences 1.
Some key factors associated with burning mouth syndrome include taste, salivary flow, clenching, bruxing habits, locking or clicking of jaw joint, altered sensation, nasal, eye, or ear symptoms, as well as other pain conditions such as headaches, migraines, chronic widespread pain, and fibromyalgia 1. It is also important to consider the impact of pain on sleep, mood, concentration, fatigue, beliefs, and quality of life.
While burning mouth syndrome itself does not directly cause cognitive issues, the chronic pain and discomfort can lead to secondary problems that may affect cognitive function, such as difficulty sleeping, irritability, anxiety, and depression 1. It is essential to assess cognitive symptoms, which can be subjective and may be influenced by cultural and linguistic factors, as well as the individual's ability to report their difficulties 1.
In terms of management, treatment typically focuses on symptom management through oral rinses, pain medications, certain antidepressants, anticonvulsants, or cognitive behavioral therapy depending on the suspected underlying cause. The most effective approach to managing burning mouth syndrome is to address the underlying causes and symptoms, and to provide supportive care to improve quality of life. This may involve a multidisciplinary approach, including dental, medical, and psychological interventions.
Key considerations in the management of burning mouth syndrome include:
- Assessing cognitive symptoms and their impact on daily functioning
- Evaluating the individual's medical and dental history, as well as their social and psychological factors
- Providing supportive care to improve quality of life, including pain management and cognitive behavioral therapy
- Addressing underlying causes, such as nerve damage, hormonal changes, dry mouth, allergies, or psychological factors
- Considering a multidisciplinary approach to management, including dental, medical, and psychological interventions.
From the Research
Primary Symptoms of Burning Mouth Syndrome (BMS)
- Burning sensation in the mouth, tongue, lips, or gums 2, 3, 4, 5, 6
- Alteration in taste, including metallic taste or diminished taste sensations 2, 3, 4
- Altered salivation, including xerostomia (dry mouth) 2, 3
- Unremitting oral mucosal pain and dysgeusia (distortion of taste) 3
- Dysesthesia (abnormal sensation) and paraesthesia (numbness or tingling) 4
Associated Cognitive Issues
- Depression and anxiety are common comorbidities in BMS patients 4, 6
- Psychiatric comorbidities, including pain disorders, are often managed with psychotropic drugs 6
- Cognitive therapy is reported as a good and lasting therapeutic option for BMS, with the advantage of not having side effects 5