written by Xander DuMoulin, Justyn Hermel, Claudia Lampi, and Tate Littlefield
Hungry, growing impatient for pizza to cool down – you’ve been there. You take a bite and the scalding hot cheese sticks to the roof of your mouth, burning you. The ensuing pain is incredibly irritating, lasting a few hours to several days depending on the severity of the burn. Eventually, the dead cells are replaced by new ones. Our mouths developed for acute sensitivity with regard to taste, but this sensitivity leaves the tissue at high risk of damage from high heat (Holland, 2019). Although only a perception, a similar experience is found in eating spicy hot foods. Our perception of this burning sensation is the result of a chemical called capsaicin found within many peppers (Lehrer, 2010). This molecule binds to receptors in our tongue originally meant for detecting temperature, thus causing us to feel an intense burn (Lehrer, 2010). These experiences are said to be comparable to a condition called Burning Mouth Syndrome, abbreviated BMS (Lehrer, 2010). This condition is rare, unbeknownst to both physicians and the general public alike – so let’s break it down.
What is Burning Mouth Syndrome? An Overview
According to the Mayo Clinic, burning mouth syndrome is the “ongoing (chronic) or recurrent burning in the mouth without an obvious cause,” (Mayo Clinic, 2019). The burning sensation can occur throughout the entire mouth, or in a select area. The cause
of this syndrome for patients diagnosed with BMS is rarely identified, often troubling doctors to find treatment plans. Although there is not one particular cause found for BMS, “one third of people diagnosed with this disease say they experience it after having a dentist appointment, going through a course of medication, or suffering from an illness” (Nazario, 2020).
Diagnosis and Treatment
Burning mouth syndrome can either occur standalone, or as a consequence of a related condition (Brunilda, 2020). The National Institute of Dental and Craniofacial Research states that primary BMS is not caused by any underlying health conditions, and it is believed to be caused by damage to nerves that control both pain and taste (NIDCR, 2021). According to The National Institute of Dental and Craniofacial Research, “symptoms of secondary BMS may go away after the underlying medical condition is treated” (NIDCR, 2021). Identified causes of secondary BMS include depression, allergies to dental products, dry mouth, infections, etc. (NIDCR, 2021). Because BMS is hard to diagnose, bringing any and all information to medical attention as soon as possible is most beneficial for quick determination. General nerve blockers or specific treatments such as oral washes and saliva replacement products can help manage BMS symptoms (Mayo Clinic, 2019). Because BMX is such a complex disorder with so many possible causes, treatments that may work for one individual may not work for another.
Presentation of Symptoms
This condition presents incredibly painful, with specifics that vary per individual with respect to the intensity of, prolonged exposure to, and recurrence of pain. Burning Mouth Syndrome is effectively named, when someone experiences this disease they describe a literal burning sensation across their mouths (Nazario, 2020). The most commonly expressed areas of pain are along the tip of the tongue, but this agonizing sensation can occur throughout the entire mouth (NIDCR, 2021). Other symptoms described with Burning Mouth Syndrome are difficulty swallowing, dry mouth, sore throat, numbness or tingling of the tongue, changes in taste, and a metallic taste in one’s mouth (Nazario, 2020).
Personal Experiences
A shared experience in those affected by this condition is the feeling of intense frustration arising from both the process of diagnosis and the reoccurring symptoms. People often change their lifestyle in response to BMS in an attempt to identify a cause and reduce symptoms. For example, an anonymous patient reports several misdiagnoses before turning to BMS, and identifying a nickel allergy as a cause (Burning Mouth Syndrome, 2022). In their life, they had to quit foods that contained nickel, such as “legumes, nuts, anything with a soy derivative, chocolate” etc. Rose, another patient, has managed this condition for five years before identifying dental restoration as the cause due to the “clear connection, a defined pattern” between symptoms and dental work, so much that she fears dental treatment (Burning Mouth Syndrome, 2022).
Where Now?
The rarity of the condition, in combination with the complexities in symptom expression, makes for difficult progress in diagnosis and research. A wide variety of causes may trigger BMS, further complicating the situation. While the matter is nothing to take lightly, the general public may be able to extend sympathy in experiencing when our nerves fire off pain following a hot bite of pizza. Our perception of the world, and things that can alter our senses, should never be taken for granted.
References
“Burning Mouth Syndrome: Causes, Symptoms, Home Remedies & Treatment.” MedicineNet, MedicineNet, 3 Feb. 2022, https://www.medicinenet.com/burning_mouth_syndrome/article.htm.
“Burning Mouth Syndrome.” National Institute of Dental and Craniofacial Research, U.S. Department of Health and Human Services, https://www.nidcr.nih.gov/health-info/burning-mouth.
“Burning Mouth Syndrome.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 14 Feb. 2019, www.mayoclinic.org/diseases-conditions/burning-mouth-syndrome/symptoms-causes/syc-20350911.
Holland, Kimberly. “How to Treat a Burn on the Roof of Your Mouth.” Healthline, Healthline Media, 8 Mar. 2019, https://www.healthline.com/health/how-to-treat-a-roof-of-mouth-burn#_noHeaderPrefixedContent.
Lehrer, Jonah. “Why Does Spicy Food Taste Hot?” Wired, Conde Nast, 22 Sept. 2010, https://www.wired.com/2010/09/why-does-spicy-food-taste-hot/.
Nazario, Brunilda MD. “Burning Mouth Syndrome (Burning Tongue): Symptoms, Causes, Treatment.” WebMD, WebMD, 27 July 2020 https://www.webmd.com/oral-health/burning-mouth-syndrome-facts
Vincent D Eusterman, MD. Burning Mouth Syndrome: Background, Anatomy and Physiology, Pathophysiology, Medscape, 23 Dec. 2021, emedicine.medscape.com/article/1508869-overview.