From the Guidelines
There is currently no established direct association between burning mouth syndrome (BMS) and Alzheimer's disease or dementia. While both conditions can occur in older adults, the research does not support a causal relationship between them 1. Burning mouth syndrome is characterized by chronic burning sensations in the mouth without visible oral lesions, often affecting the tongue, lips, palate, and gums. It's typically managed with medications like clonazepam (0.5-1mg daily), alpha-lipoic acid (600mg daily), or topical treatments such as lidocaine rinses. Some patients benefit from low-dose antidepressants like amitriptyline (10-25mg at bedtime).
Key Considerations
- Both BMS and dementia can involve neurological components—BMS may result from nerve damage or dysfunction in pain perception pathways, while Alzheimer's involves progressive neurodegeneration.
- Some medications used for dementia might occasionally cause dry mouth, which could exacerbate BMS symptoms.
- If you're experiencing burning mouth symptoms alongside cognitive changes, it's essential to consult healthcare providers for proper evaluation of each condition separately, as they likely require different treatment approaches despite potentially overlapping in older populations.
Management and Treatment
- The prognosis for BMS is poor, with only a small number resolving fully; however, patients can be reassured that it will not get worse, and this is often crucial 1.
- Secondary causes of BMS (local and systemic) include oral candidiasis, mucosal lesions, haematological disorders, auto-immune disorders, and pharmacological side-effects, which should be ruled out and managed accordingly.
From the Research
Association between Burning Mouth Syndrome and Alzheimer's disease or dementia
- There is evidence to suggest a potential link between Burning Mouth Syndrome (BMS) and cognitive decline, particularly in the domains of attention, working memory, and executive functions 2.
- A case report describes a patient with BMS who later developed dementia with Lewy bodies, highlighting the importance of careful interviews and collaboration with specialists in managing BMS patients with potential cognitive decline 3.
- However, a retrospective population-based cohort study found no association between BMS and the risk of developing dementia or Parkinson's disease, although it did find an increased incidence of depression and anxiety in BMS patients 4.
- Another study found that symptom severity in BMS associates with psychological factors, including depression, pain anxiety, and pain vigilance, emphasizing the need for multidimensional diagnostics in assessing BMS pain 5.
- The relationship between BMS and cognitive impairment is complex, and further research is needed to fully understand the potential link between BMS and Alzheimer's disease or dementia, with one study suggesting that early identification of cognitive impairment in BMS patients may help identify those at risk of developing neurodegenerative disorders 2.