Q: My mother has been experiencing her tongue burning for two years and there is no solution we know of. What’s next?
A: Unfortunately, it is often difficult to determine the cause of burning mouth syndrome, a sensation that appears without any apparent cause. Common symptoms may include a loss of taste, dry mouth and increased thirst, a metallic taste in the mouth, and a burning sensation that may affect the tongue, lips, throat, or whole mouth. Interestingly, there is a pattern for this syndrome that varies from person to person. It may occur every day and all day, subside somewhat on awakening, and increase in intensity as the day goes on. The condition may last for months or even years, as your mother can attest to. There are rare instances when it will dissipate completely in some individuals or will at least become less frequent and intense.
This condition is broken down into two categories – primary and secondary. When an examination and lab testing fail to find a cause for burning mouth, it is referred to as idiopathic and primary. Some researchers feel there is a connection with the taste buds and the sensory nerves of the central and/or peripheral nervous system. When a cause can be determined, the condition is referred to as secondary burning mouth syndrome. Such underlying causes may include a fungal infection of the mouth (known as oral thrush), poorly fitting dentures, allergies to foods or food additives such as MSG, having gastroesophageal reflux disease, dry mouth caused by a dysfunction of the salivary glands, by some medications (particularly those taken for hypertension), or from the side effects of cancer treatments. Nutritional deficiencies including vitamin B1, B2, B6, B9, B12, iron or zinc, hypothyroidism, and even stress may be contributory.
Factors that may increase a person’s risk of acquiring burning mouth syndrome include having an upper respiratory tract infection, anxiety, stress, allergic reactions to specific foods, and more.
Because the possibilities for your mother’s condition are numerous, she will require an examination, laboratory testing, possible MRI or CT to rule out other health issues, a culture for bacteria, or biopsy of the mouth to determine if a viral infection is present, and perhaps more. Her lab work should include at least a complete blood count, sugar level, vitamin and thyroid panels, and perhaps more. She will also need to provide a complete history to her primary care physician to review the medications she may be taking, when she first noticed the symptoms, if she has incorporated any dietary changes, and anything else that may have a bearing. She must remember that what may appear insignificant to her may be extremely important to her physician. For example, she might be taking an herbal supplement or pick-me-up tonic she saw advertised on television that has an adverse effect on her. With a little luck and a physician who is thorough, you just might find the answers to make her life much better. Good luck.
