Burning Mouth Syndrome

The Real Scoop on BMS

Are you plagued with burning in your mouth or tongue, sometimes called glossodynia? Have you been to numerous doctors, dentists, allergy experts, or ear, nose & throat specialists who say everything looks normal?

Listen to this story. Jeannie, a vivacious 42-year-old mother of two children is a massage therapist and chef. She was living the idyllic life in beautiful northern California until burning mouth came into her life. She has severe burning pain throughout her mouth and tongue.

It started two years ago. Her life has become a living hell since then. She is not able to enjoy the great food she makes. She has a 45-minute routine to use mouthwashes and pastes in her mouth in order to fall asleep. She doesn’t have a life-threatening condition, but her life is miserable due to burning mouth.

She has seen eight different health practitioners. She has been to a dentist, allergist, ENT (ear, nose, and throat) specialist. She has seen alternative health practitioners including an acupuncturist, a nutritionist, and a homeopathic practitioner. She saw a naturopathic doctor who supposedly treated her with hormones, but they didn’t work.

According to a review article on burning mouth syndrome in the International Journal of Oral Sciences:
“Most clinicians DREAD seeing the patient presenting with a primary complaint of burning pain on one or more oral mucosal surfaces (the lining of your mouth and tongue).”

DOCTORS DREAD SEEING YOU! WHY?
Because they don’t know what to do for you!

WHO AM I?
I’m Dr. Susan Sklar. I have formally trained as an Obstetrician-Gynecologist 35 years ago. For the past 5 years, I have been treating men and women with bioidentical hormones at my Restorative Medicine Center. I have had the opportunity to observe women closely for the past 35 years. I have witnessed the tremendous changes that occur in some women with changes in their hormones. I didn’t start out to treat women with burning mouth and tongue, but I noticed that as I treated them for hormone imbalances and deficiencies with a full restorative hormone program, their burning tongue and mouth improved or went away. So did burning skin and itching skin on shoulders, backs, waists, and thighs. There is solid scientific evidence for why this is true.

WHAT IS BURNING TONGUE SYNDROME or BURNING MOUTH SYNDROME?
How do you know if you have burning tongue/ burning mouth? Most importantly, you feel like your tongue or mouth has been scalded or burnt by hot liquid. Burning tongue and mouth is defined as “an intraoral (in the mouth) burning sensation for which no medical or dental cause can be found.”(International Headache Society). The burning sensation occurs on a daily basis and is present for 4-6 months.

The pain is usually gone during sleep but starts in the morning, becomes mild to moderate by late morning and may progressively increase through the day, reaching its worst level by late afternoon or early evening. The pain often interferes with falling asleep.

Earlier medical studies minimized the severity of the pain, but more recent studies have reported that pain is moderate to severe and is similar to the intensity of toothache pain.

The medical establishment has been underestimating the severity of your pain. It’s a high level of pain!

You may also have dry mouth, itching, feeling of roughness, a “sticky sensation”, trouble swallowing, a metallic taste or other taste changes. Usually, the onset is spontaneous, but sometimes there is a specific event which started it such as a dental procedure, illness or medication. Once burning starts, it often persists for many years.

There isn’t much information on the natural course of burning mouth/burning tongue syndrome, but some studies have shown partial recovery without treatment six to seven years after it starts. That’s a long time to wait to see if maybe it’s going to go away!

WHAT IS THE CAUSE OF BURNING MOUTH/BURNING TONGUE SYNDROME?
What you are up against:
1) Doctors who believe that depression is the cause
2) Doctors who think anxiety is the cause
3) Scientists who think fear of cancer is the cause

They are saying it’s all in your head! They think you are worrying yourself into burning mouth syndrome. They are also saying that because you are depressed, normal sensations are being perceived as painful. You know it’s not normal. I know it’s not normal. Because doctors can’t figure it out, they are blaming you, the person with burning mouth syndrome. The more enlightened doctors say you’re depressed because of the pain. That’s more like it. Of course, chronic pain is depressing, especially if your sleep is affected.

The most enlightened scientists in the medical establishment say burning tongue is a nerve problem.They’re right, but what is their solution? Put you on an anti-depressant medication or worse yet, an addictive anti-anxiety medication like valium. Don’t do this.

WHO GETS BURNING TONGUE AND BURNING MOUTH SYNDROME?
Who gets burning tongue? Primarily women! And primarily women in menopause!

Read a portion of this report from the journal of the American Academy of Family Practice:
“Based on the makeup of most studies published to date, oral burning appears to be most prevalent in postmenopausal women. It has been reported in 10 to 40 percent of women presenting for treatment of menopausal symptoms. “

The medical establishment has tried to blame it on depression and anxiety. 90% of women in the studies of burning mouth and burning tongue are menopausal. When the primary people suffering are women, it’s easy for the medical establishment to write it off to emotional problems. This is so unfair to women.


WHAT YOU NEED TO KNOW ABOUT BURNING MOUTH/BURNING TONGUE SYNDROME
You need a lot of patience. Scientific studies show that the average time to diagnosis is 3 years. Yes, that’s 3 years of going to doctors, dentists, specialists, alternative practitioners. That’s 3 years of sleeplessness, pain, frustration, and thinking that you’re going crazy. That’s how long it takes to find out that you have burning tongue or burning mouth. Once you find out, then you need to find a solution.I’m hoping to shorten that time for you by giving you this information.

First of all, a diagnosis is needed. You do need to see at least one competent ENT (Ear, nose, and throat) specialist, dentist or allergist to examine your mouth and tongue. Poorly fitting dental work and allergies to dental materials can cause similar symptoms. Yeast on the tongue and in the mouth can cause discomfort and should be searched for and treated if present. Skin conditions and herpes can also cause a burning sensation, so eliminate these as a possibility first. If you have dry mouth, get checked for Sjogren’s syndrome, an autoimmune disorder.

Some scientists blame burning mouth on compulsive biting or chewing on your mouth or tongue, but you know it’s burning and you’re not compulsively doing anything. Burning tongue has been blamed on allergies to nylon and nickel, so stop chewing your pantyhose and necklaces. If you are told that everything looks normal and you still have the burning and it has been going on for 4-6 months, then you can be confident that you have burning tongue.

WHAT TO DO NEXT
If you are smoking—STOP. That is an obvious irritant. There are other important reasons to stop also.

Look at the medications you are currently taking. Did you start a new medication just before your symptoms started? The most common medications that can cause burning mouth and tongue are in the blood pressure lowering family of medications called ACE inhibitors. These are things like Lotensin and Prinivil. If you are taking this medication, speak to your doctor about changing to a different type of blood pressure lowering medicine. Antihistamines used for the treatment of hayfever, anxiety lowering medications like Valium, and certain heart medications can be the cause of burning tongue and mouth. Review your medications, but do not stop them by yourself. Speak to your doctor about a substitute medicine.

Get your nutritional and metabolic status checked. Deficiencies in certain vitamins can contribute to burning tongue and mouth. Diabetes can cause mouth burning.

Ask your doctor for the following blood testing: Vitamin B12, Homocysteine, blood sugar and hemoglobin A1C, iron and TIBC, anemia testing.


WHAT NOT TO DO:
Don’t bother with mouth rinses of anti-inflammatory substances or prednisone. They don’t work. Don’t bother with numbing gels and rinses. They will cause worse pain. Don’t bother with capsaicin. It is hot chili peppers. It tastes terrible and causes stomach pain after 4 weeks in fully a third of people who use it.

Do not get treated for anxiety or depression or get treated with medication used to treat anxiety or depression. The anxiety medications are ones like Valium, Klonopin or Librium. They will sedate you and they are highly addicting. Don’t end up with an addiction problem in addition to your burning mouth. Some doctors have used Klonopin in a lozenge to melt on the tongue with some success.

The antidepressant medications like Elavil that are proposed have a number of side effects. For one thing, dry mouth. If your mouth is already burning and especially if you have dry mouth also, you will not want to use these. Other side effects with Elavil include sleepiness, dizziness, heart arrhythmias, strokes, seizures, tremor, and constipation. Does that sound like a good solution? And they have not been shown conclusively to be effective.

What about other anti-depressants like Prozac. Well, first of all, depression is not the cause of your burning tongue. Yes, you may be depressed by the time it took to diagnose it and by the frustration in getting it treated. But think carefully before using anti-depressants. They have lots of side effects—weight gain, decreased sex drive, permanent changes in your brain chemistry and sometimes withdrawal symptoms when you try to go off. And—they have not been shown to be effective either.

What about using anti-seizure medications? These have been proposed for use in a number of pain syndromes. They change the nerve conduction of the pain nerves. These may help but beware of side effects like sedation and feeling like a zombie. They have not been proven to be effective for Burning Mouth Syndrome.

DO NOT—I repeat—DO NOT have laser to your mouth and tongue. Burning the daylights out of your delicate linings is not a long-term solution and may affect your ability to taste in the future.

While the medical establishment tries anti-depressant medications, anti-anxiety medications and anti-seizure medicine to relieve symptoms, they don’t treat some of the root cause—hormone deficiencies.They say they’ve studied hormone treatments, but they have only looked at estrogen. Results are mixed and, in addition, this is not enough to study.


WHAT’S THE SOLUTION?
The solution is to treat the underlying problem which causes burning mouth and tongue. You do not have a deficiency in Prozac or Librium. You do have deficiencies in many steroid hormones. Why is this? For one thing, you are probably menopausal or perimenopausal. Your hormone levels have been declining for years and now have reached a critical level. Added to this is stress. And who isn’t stressed? The modern world, our demanding lives, past trauma, and illnesses can cause a stress response in your body that depletes your important neuroactive hormones. These are hormones that specifically act within the nerves in your body. Seeing professionals who examine the surface of your tongue and mouth is important for diagnosis and exclusion of oral disease, but will not provide a solution. The problem is not visible. It is in the nerves. The deficiencies in your hormone levels are causing malfunction in your nerves. This Is what is causing your burning tongue and mouth.

What can be done? You need to see a doctor who has expertise in anti-aging medicine. These are doctors who recognize that hormones are important regulators of your health. They govern your nervous, reproductive, immune, and metabolic functions. Get on a program of full hormone restoration. Your best chance at recovery is to be under the care of a specialized anti-aging doctor.

For those who are not able to locate an anti-aging specialist, or who cannot afford the services of this type of doctor, we developed BMS Advanced Support. In the form of a nutritional supplement, it contains some of the hormones and vitamins that are known to help heal nerves.


 

 



 

 

Listen to Dr. Sklar's California Dental Association 2012 Lecture

 

 


Sklar Center for Restorative Medicine
5000 East Spring Street
#402
Long Beach, CA 90815