Oral Dysesthesia – Burning Mouth Syndrome

Oral dysesthesia is pain that originates in the central nervous system. It’s usually associated with patients that have multiple sclerosis (MS), but patients with diabetes, Lyme disease and Guillain–Barré syndrome also have oral dysesthesia. Patients who have other types of neuropathy often also have oral dysesthesia as well.

What is Oral Dysesthesia?

Oral dysesthesia is often called burning mouth syndrome (BMS) or glossodynia. It is one of a group of chronic orofacial pain (COFP) disorders. The pain creates a burning or electrical shock sensation in the mouth. It can also happen in other parts of the body, like the scalp, legs and feet. The sensation is intermittent in some people and continuous in others. Some patients experience a dry mouth sensation or a change in taste. Patients say hot foods make the pain worse and cold foods make it better.

What Causes Oral Dysesthesia?

Damage in the central nervous system causes the pain. For example, MS patients develop lesions and scar tissue in the spine and brain, and the scar tissue interferes with the electrical signals traveling between the brain and body.

The cause of oral dysesthesia is unknown, and there is no specific test to diagnose it. Older adults over age 60 tend to have it. Oral dysesthesia is rarely seen in people under age 40. Women experience it much more frequently than men, and researchers feel the disorder may have something to do with hormone changes that occur during menopause.

Treatment For Oral Dysesthesia

Doctors will usually first try over-the-counter anti-inflammatory medications to control symptoms. Patients who don’t respond to that treatment and continue to have severe pain are often prescribed opioids like oxycodone. Doctors will also sometimes prescribe antisiezure drugs like Neurontin or Lyrica or even antidepressants like Cymbalta. Antihistamines and lidocaine have also been used, as have muscle relaxers like Baclofen or Flexeril.

Patients who don’t respond well to medications sometimes resort to a nerve block operation to stop the nerve transmissions altogether.

Frequency Of Oral Dysesthesia

Of all the COFP disorders, oral dysesthesia is fairly rare. Even rarer is a condition called spontaneous oral dysesthesia, which some patients report suddenly developing after dental procedures or after wearing dental appliances. Most dentists will assume the condition is temporary, and most of the time it is because the sensations are a residual effect of the anesthesia or gum trauma and will resolve over time.

When conditions don’t resolve, and the patient continues to experience these sensations, dentists will refer the patient to an orofacial specialist.

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