Burning Mouth Syndrome This is defined as a burning pain affecting the mouth or tongue, occurring daily for at least 2 hours a day, over more than 3 months, for which a medical or dental cause cannot be found. It tends to be chronic and disabling. It can affect up to 18% of postmenopausal women. The pain is described as burning, tender, tingling, hot, scalding, numbing, and the anterior tongue is the site most affected. In two-thirds of patients, it is termed “primary,” meaning there is no defined cause. Possible causes in the other third include Sjögren’s syndrome, an autoimmune disorder; iron or zinc deficiency; badly fitting dentures; toothpaste that contains sodium lauryl sulfate; oral candidiasis; smoking; acid reflux; B12 deficiency; perhaps alcohol. Anxiety and depression are common in these patients. They may also have a sensation that their mouth is dry even though the amount of saliva they make is normal. In Sjögren’s syndrome, the saliva production is indeed reduced. Some patients report that eating reduces pain. Treatment is difficult, and studies are inconsistent. Most patients have tried antianxiety drugs, antidepressants, antiepileptic drugs, supplements. There are reports of topical clonazepam, a benzodiazepine, being helpful. Cognitive therapy may help as…
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