DEAR DR. GOTT: I am a 67-year-old female. Starting around Thanksgiving 2009, I have had a burning on the inside of my bottom lip. I hadn’t been sick, and the only prescription I was taking at the time was a hormone. I also took over-the-counter Benadryl (I have bad allergies) and something for my stomach.
My doctor diagnosed me with glossopyrosis. He has tried several prescriptions, but they only work for a few days. The newest was Nystatin with Benadryl and tetracycline, plus four others that I don’t remember. It only helped for two days.
I always use the medications as directed and never eat spicy foods. My ear-nose-and-throat doctor says sometimes it resolves itself but can reappear. I have not seen this topic in your column before but am hoping you have some suggestions.
DEAR READER: Glossopyrosis is also known as burning-tongue syndrome, which is another name for burning-mouth syndrome (BMS). To confuse the issue further, this condition is also known as glossodynia, stomatodynia, scalded-mouth syndrome and burning-lips syndrome. Despite the plethora of names, the condition is defined as a chronic burning pain of the tongue, gums, lips, inside of the cheeks, roof of the mouth or the entire mouth.
The cause of BMS often cannot be identified, making treatment more difficult. Control is possible, however. Occasionally, symptoms cease on their own or become less frequent or severe.
Symptoms include increased thirst, a tingling or numb sensation of the mouth or tip of the tongue, mouth pain that worsens as the day progresses, loss of taste, taste changes (bitter, metallic, etc.), a sore mouth, a sensation of mouth dryness and, most notably, a burning sensation of part or all of the mouth.
Symptoms may occur in patterns that worsen during the day, come and go throughout the day (sometimes with pain-free days) or pain that begins upon waking and persists at the same level throughout the day.
There are three types of BMS: primary, idiopathic and secondary. Primary is thought to be related to problems with taste and sensory nerves. Idiopathic means no identifiable cause. Secondary is caused by an underlying medical condition and is most easily linked to dry mouth, the use of dentures, nerve damage, nutritional deficiencies, allergies, gastroesophageal reflux disease, psychological factors, certain medications, hormonal imbalances, excessive mouth irritation, oral habits (such as grinding the teeth) or other oral conditions.
Treatment options include B vitamins, saliva-replacement products, treatment of any contributing underlying medical condition, special oral rinses or mouthwashes, capsaicin, cognitive behavioral therapy and more. Home remedies include drinking extra fluids to ease mouth dryness, reducing stress, changing toothpaste brands, and avoiding tobacco, products that contain cinnamon or mint, and acidic foods and liquids such as citrus fruits and juices, sodas, coffee and tomatoes.
If you have not already done so, sit down with your doctor to discuss any medications you may be taking that could cause BMS. Request testing to determine if there is a underlying cause. If there isn’t, continue to work with your physician to determine which medication or combination provides control and relief. It may take some time, but hang in there and you will likely find the right modification.
To provide related information, I am sending you a copy of my Health Report “Managing Chronic Pain.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.
