Burning mouth syndrome (synonyms: Glossalgia; Glossodynia; Glossopyrosis; ICD-10: K14.6 – Glossodynia) is the burning of the tongue and oral mucosa. About five percent of the population is affected, women suffer significantly more often from the disease.
Tongue burning can occur alone or in combination with oral mucosal burning and can be caused by a variety of factors. As the day progresses, the discomfort usually increases.
Symptoms – Complaints
In addition to burning, other sensory disturbances may occur, such as tingling, itching, or stabbing pain. Not infrequently, the discomfort is so great that any food intake becomes a torment.
Other accompanying symptoms may include xerostomia (dry mouth) or disturbances in the sense of taste.
Consequential diseases
There are no known sequelae.
Causes
Prostheses are often responsible for mucosal burning. Both poorly maintained prostheses and ill-fitting prostheses are possible triggers of mucosal burning. Likewise, denture intolerance can lead to mucosal burning, which is referred to as denture stomatitis.
Other possible triggers of burning mouth syndrome are allergies. These include dental materials such as plastics or metals, but also noxious substances such as nicotine or alcohol. Many foods also represent possible allergens if allergy potential is present. If an allergy-related burning of the tongue or mucous membrane is suspected, an allergist should be consulted.
Another condition associated with burning tongue is a fungal infection with Candida albicans, which can be treated with medication.
Likewise, vitamin deficiencies can lead to unpleasant burning discomfort. Here, particular reference should be made to megaloblastic anemia due to a vitamin B12 or folic acid deficiency.
Other possible causes are: Diabetes mellitus (diabetes), gastroesophageal reflux (reflux of stomach contents into the esophagus) and psychological causes.
Nevertheless, burning mouth syndrome can also occur idiopathically (without an identifiable cause), which makes treatment much more difficult. The condition is often seen in postmenopausal women suffering from psychological distress such as stress or depression.
Diagnosis
A burning tongue may be accompanied by visually visible changes in the tongue, which makes diagnosis much easier. However, even an inconspicuous-looking tongue or mucosa may be affected by burning. Possible visual signs of tongue burning are lingua geographica (map tongue) or lingua plicata (wrinkled tongue). Mainly the tip and sides of the tongue are affected by burning.
Therapy
As part of adequate therapy, the first step is to determine the cause of tongue burning and, if possible, treat it. If this is not possible due to the multitude of possible causes, a local therapy can help to initially alleviate the symptoms.
For this purpose, herbal remedies such as chamomile, myrrh or sage as well as antibiotics and surface anesthetics (superficial anesthetics) are used. Furthermore, alpha lipoic acid, capsaicin or clonazepam may be considered for local application.
In the case of idiopathic burning tongue, the following medications are also used:
- Benzodiazepines (tranquilizers).
- Tricyclic antidepressants
- Anticonvulsants (drug used to treat epileptic or seizure disorders).
In general, it is important to exclude possible diseases as the cause of burning mouth syndrome and to treat symptomatically to relieve the often great suffering of patients and restore the quality of life.
