Search results for burning mouth

Whole lotta burning going on

Posted by on Feb 18, 2013 in oral health | 0 comments

flamy symbolPain, burning, tender, tinging, hot, scalding, numb. Does this sound familiar? I suspect that it’s time for a proper update on burning mouth syndrome (BMS), a burning sensation/pain on the tip of the tongue, the lips or other oral mucous membranes. And one of the most troubling aspects of BMS is that most studies suggest that the majority who suffer are middle-aged women in menopause. In fact, the female to male ratio of BMS is a whopping 7 to 1.

According to a review in the International Journal of Preventive Medicine, women with BMS complain that it’s least bothersome upon awakening and then reappears after the first meal of the day. The pain tends to increase with intensity as the day turns into night, and it may interfere with the ability to fall asleep (lord knows many of us already deal with sleep issues due to hormones). BMS can cause irritability, anxiety, depression and no wonder! Mouth pain and burning and tingling..oh my…not to mention taste disruption.

Speaking of hormones (it seems that that’s all we speak about on this blog), many theories abound as to the cause of burning mouth syndrome but none are more intriguing than some fairly recent data that suggest that it is directly related to chronic stress, that, in turn, alters the production of steroids by the adrenals and affects the nerve endings in the skin and tissue and nervous system that also produce steroids. Menopause is the icing on the cake; during menopause, there is a dramatic fall in sex steroids that interact with androgen and estrogen. This turn of events work in concert to create a perfect storm of hormonal cacophony, potentially setting your mouth aflame.

Short of understanding the ‘how’ and ‘why,’ what can you do? Treatment is clearly directed at symptoms. If you experience BMS, you need to see a practitioner for a thorough examination and series of lab tests to rule out other more definitive causes, like diabetes, or vitamin deficiencies. Your health team, a dentist, endocrinologist, dermatologist and naturopath or gynecologist need to work together to help you obtain relief. While topical drugs like clonazepam may help, you may prefer to go the natural route. There is evidence that capsaicin rinse (e.g. hot pepper sauce), mixed with water in a ratio of 2:1 and applied up to three times a day may help reduce pain and burning. Acupuncture may also help; a recent (albeit small) study shows that 20 sessions over 8 weeks significantly reduced oral mouth pain. Another review was more impressive and suggests that either acupuncture or acupressure may be of benefit for BMS. Interestingly, the evidence for alpha-lipoic acid supplement or alpha-lipoic acid plus HRT is very sparse at best; a recent review has rated both strategies as having low quality evidence of their value in alleviating BMS pain. Unfortunately the same is true of cognitive behavioral therapy.

It’s a bit frustrating, isn’t it? Like many nerve-related conditions, there is benefit is trying different strategies to see if one works best for you. Meanwhile, work on the stress aspect of BMS. It may reduce some of that lotta burning.


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Tears dry? Dry mouth? Chapped lips? Must be the ‘pause

Posted by on Mar 9, 2012 in aging, dry mouth | 4 comments

A friend recently asked if I had run across any research papers linking chapped lips to menopause. Although I’ve not seen that direct association, I can tell you menopause is linked with dry mouth as well as burning mouth syndrome, i.e. burning in the tongue or oral mucous membranes and taste alterations.

In so far as dry mouth and burning mouth syndrome go, the tissues in the mouth and the salivary glands both contain estrogen receptors. Consequently, hormone fluctuations, like those associated with menopause, can affect the mouth, lips, tongue and even lead to periodontal disease. The rub is that although researchers are aware of this, the data are pretty scarce, although studies have shown that saliva, which by the way, is the primary defense against oral disease, is more productive in premenopausal compared to postmenopausal women. Moreover, it appears that psychological stress can also influence saliva flow, since it affects the nervous system. In some ways, it’s similar to an endless loop: oral discomfort relating to dry or burning mouth can lead to unpleasant sensations and anxiety, which then activates the autonomic nervous system and further reduces saliva.

Although there is not cure for either issue, there have been small but inconclusive studies indicating that hormone replacement may help. Dry mouth can be counterbalanced by drinking at least 1 to 1.5 liters of water or other liquid daily, or using commercial mouthwashes especially formulated for dry mouth. For burning mouth syndrome, there are commercially available gels and ointments, and some practitioners recommend rubbing olive or other vegetable oil to the oral tissues. Short of that, severe cases may benefit from antidepressants or probiotic products. For chapped lips? Personally, I am pretty hooked on the Pangea Organics line of lips products but I recommend that you use what feels best. Finally? Be sure to maintain your oral health by seeing the dentist regularly. It’s essential!



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Wednesday Bubble: is there a connection between dry mouth and osteoporosis?

Posted by on Jun 1, 2011 in bone health, dry mouth, osteoporosis | 0 comments

This week’s bubble is neither burstable or good news. But it is important:

Dry mouth and bone mineral density appear to be related.

Say what?!!!

A bit of background is needed…

Osteoporosis is fast becoming a major health problem and as I’ve written time and again on this blog, is a significant characteristic of menopause, namely as the result of waning estrogen levels that lead to an imbalance between the build up and turnover of bone cells. Parathyroid hormone and cortisol have also been linked to bone turnover.

Dry mouth (i.e. a feeling of dryness in the mouth and need to use liquids while eating) and burning mouth syndrome (i.e. burning in the tongue or oral mucus membranes and taste alterations) are also common during menopause, affecting up to 40% of women. Until now, experts have not been able to adequately determine why these symptoms occur and more importantly, effective management strategies.

The link? Recent data have shown that estrogen levels may be significantly lower and both parathyroid and cortisol levels significantly higher in menopausal women who complain of dry mouth. Moreover, as the results of a new study in Menopause show, there may be a true relationship between these two conditions and that bone loss may be the actual cause of oral dryness and related symptoms. In this study, researchers evaluated 60 women in menopause (mean age 56) for the presence and severity of dry mouth and then based on their results, divided them into two groups. Dry mouth was confirmed by responses to a scientific questionnaire and collections of saliva. The researchers also measured bone mineral density at the spine.

Importantly, the participants were not particularly active and none engaged in any sports activity, except walking. The women were also matched by body mass index, age, or years of menopause. And yet, women with low bone mineral density, including relationship to other women in the same age group and 30 years younger, were significantly more likely to experience dry mouth and had significantly less saliva when their appetites were not stimulated.

Clearly, more research is needed. However, there are some things you can do now. The first strategy to combat osteoporosis and bone loss is to get measured for bone loss and disease markers. Steps like calcium supplementation, a healthy diet and regular exercise are critical. And if you suffer from dry mouth? You may want to speak to your dentist about a referral for a bone mineral density scan or better yet, have him or her contact your gynecologist or regular health practitioner for a pow wow. Not only may you help your bones, but you may actually change that dry feeling.

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Wednesday Bubble: bisphosphonates…enough to make your jaw drop

Posted by on Jun 2, 2010 in bone health, oral health | 0 comments


Are you being treated for osteoporosis? Has your doctor told you about a rare but extremely serious side effect of drugs known as bisphosphonates that causes the jaw bone to collapse?

Osteonecrosis is a disease that occurs when the blood supply to bone is cut off. This results can result in pain, limited range of motion and an eventual collapse of the bone in the affected area. According to the American Dental Association, reports of jaw osteonecrosis among very small numbers of patients taking Fosamax for osteoporosis started to emerge in 2003.  At higher risk were cancer patients who were receiving intravenous bisphosphonate therapy as part of their treatment. In the majority of patients, osteonecrosis developed after dental surgery.

As I’ve written previously, osteoporosis and low bone mineral density are well-known issues for menopausal women. Studies have shown that after age 35, women (and men) start to lose their bone density at a rate of 0.3% to 0.5% a year.  However, as estrogen levels decline through menopause, the rate of bone density loss accelerates. In fact, during the first five years after menopause, women can experience as much as a 30% loss of bone density. What’s more, experts estimate that by the time a woman reaches the age of 50, she has a 40% risk of suffering a fracture due to osteoporosis for the rest of her lifetime.

Bisphosphonates are frequently prescribed as an alternative to estrogen therapy for preserving bone mass during menopause. Although less than 1% of jaw osteonecrosis have been reported in patients taking oral bisphosphonates, recent research suggests that the majority don’t know about possible side effects. In fact, in this particular study of 71 women and 2 men, 82% said they couldn’t recall or were unsure if their physicians had told them about jaw osteonecrosis.

What you need to know

Taking care of your mouth is essential at any age but particularly during menopause. During the transition, women are especially at risk for altered taste and burning mouth syndrome. Additionally, we are learning that the drugs that we take to prevent loss may actually cause bone death in some women.

The American Dental Association recommends that patients inform their dentist and hygienist that they are taking bisphosphonates to prevent osteoporosis so that extra precaution can be taken before any routine or major dental procedures. if you start to experience the following signs and symptoms while taking bisphosphonates, call your doctor and dentist immediately:

  • pain, swelling
  • gum or jaw infection
  • gums that don’t heal
  • loose teeth
  • jaw heaviness or numbness
  • impaired range of motion
  • exposed bone

Undoubtedly, the benefits of bisphosphonate therapy definitely outweigh the risks. Still, it is unclear whether or not bisphosphonates will ultimately prove to be as risky as HRT, as there have also been reports of  hip fractures in a very small amount of women taking these drugs for five years or more.

Unfortunately, there are few medicinal alternatives available in the United States, although a new drug Prolia, was approved for treatment of osteoporosis just yesterday. I don’t know much about Prolia, other than it is an agent that has been widely used in treating cancer patients. However, there are some early indications that Prolia might also cause jaw osteonecrosis. Only time will tell.

Meanwhile, I can’t emphasize enough that physical activity and ample calcium and vitamin D intake are essential. The risk of doing nothing now? Enough to make your draw drop…literally.

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The Roundup: October news and tidbits

Posted by on Oct 30, 2009 in Uncategorized | 0 comments

roundup copy

[Credit: Special thanks to artist Darryl Willison of Please visit his site and support his work!]

Wow! Where did October go? I missed most of it; hope you didn’t miss a thing. If so, here’s the month’s Roundup:

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