BURNING TONGUE SYNDROME

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If the lining of your mouth around your lips is sensitive and your tongue feels like you have burned it (but you haven't), you may be described as having glossopyrosis, which translates as "burning tongue."  It is important to realize that glossopyrosis is a term that describes a symptom (like vertigo for whirling dizziness, or neuralgia for pain) and is NOT a diagnosis.

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Glossopyrosis, oddly enough, almost always occurs in postmenopausal women. While this would suggest a strong hormonal connection, many women with this problem are on appropriate levels of estrogen supplements. Nevertheless, if a postmenopausal woman with these symptoms is not taking an estrogen supplement, she might ask her internist or gynecologist if she is an appropriate candidate for estrogen therapy. (As you may know, estrogen supplementation is controversial in women who have a personal history of breast cancer, or even a strong family history of breast cancer.)

There are many other possible causes of glossopyrosis:
 

• Vitamin B deficiency. Several of the B vitamins have been implicated, and many people have speculated about deficiencies of other vitamins or minerals (especially folate). Consequently, affected patients should consider taking a multivitamin and mineral daily, if he or she is not already doing so.

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• Oral yeast infection (thrush). While this is often obvious on examining the mouth, it can, on occasion, be a very subtle infection.
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• Sensitivity to toothpaste, mouthwash or denture-cleaning agents. Most of these substances contain a detergent called sodium lauryl sulfate.  Many “tartar control” formulas contain “soluble pyrophosphates”.  A number of patients note great improvement of their symptoms if they eliminate these substances entirely. You can find some alternatives, including Tom’s Of Maine toothpaste, in many stores. Just make sure that your toothpaste contains FLUORIDE !!
   

• Plummer-Vinson syndrome. This is a group of symptoms related to iron deficiency. It includes anemia, a variety of oral lesions, "spoon-shaped" fingernails and webbing of the esophagus.
   

• GERD (gastroesophageal reflux disease). Reflux (backflow) of stomach acid and digestive enzymes into the esophagus and mouth can theoretically cause glossopyrosis.
   

• Idiopathic causes. When doctors don't know what has caused a problem, they say the cause is "idiopathic." That sounds much better than "I don't know." Unfortunately, many cases of glossopyrosis are idiopathic.

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Treatment:

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Doctors have devised a variety of "magic cocktails" for burning tongue syndrome. These cocktails include substances such as steroids, antifungal drugs, antibiotics, antihistamines, Milk of Magnesia and artificial flavors and colors (we're not kidding!).  Unfortunately, the results are often disappointing.
 

The bottom line?  There is no simple, clear answer to burning tongue syndrome.  But we will do our best to see that you receive the most effect current care to identify and treat your particular problem.