Glossodynia is still a subject of controversy. Its mechanism is shrouded in mystery.
Even now, researchers are studying all the possible causes for glossodynia to determine the best treatment and course of action.
Definition
Glossodynia, also known as burning mouth syndrome, is a burning pain in the tongue or other oral mucous membrane, lasting at least 4 to 6 months, associated with normal signs and laboratory findings.
Types
- Secondary: Glossoalgia. It is linked to a loco-regional or general cause.
- Primary or essential: Burning mouth syndrome (stomatodynia).
Causes:
1/ Secondary glossodynia:
- Bruxism
- Maladjusted dental appliance
- Bimetallism: Electrolytic interaction between 2 metals and saliva
- Glossitis
- Oral mycosis
- Allergy: Food, medication, makeup, toothpaste
- Gastroesophageal reflux…
2/ Primary glossodynia:
Its causes are still a subject of discussion. Several hypotheses have been proposed:
- Neuropathic origin
- Hormonal changes during menopause
- Depression
- Anxiety
- Neuronal inflammation…
Diagnosis:
-A thorough examination of the oral mucosa in search of a lesion
-An examination of the teeth
-Examination of the tongue to eliminate glossitis
-Salivary tests associated with a salivary gland biopsy if necessary
-Mycologic sample
-Neurological test to eliminate a central or peripheral neuropathy
-A complete blood count to eliminate the possibility of anemia tongue
-Sedimentation rate to eliminate an organic disease
-Measurement of the serum levels of iron, zinc, folate, vitamin B1, B6, B12
-Blood sugar test to eliminate diabetes
-Oestrogen and progesterone levels in case of menopause
Who are at risk of glossodynia:
Primary glossodynia affects mostly women between 40 and 60 years old. It is usually associated with menopause and psychological disorders.
Contributing factors to glossodynia:
-Dental occlusion disorders
-Oral tics
-Xerostomia (Dry mouth)
-Allergies
-Bacteria, fungus, or viruses
-Diabetes
-Thyroid dysfunction
-Menopause
-Certain medication
-Nutritional deficits (vitamin B1, B2, B6, B12, folic acid, iron, zinc)
Symptoms:
*Burning mouth
The tongue is painful and feels like it is burning or tingling.
In the case of primary glossitis, the pain starts after waking up. It reaches its peak at the end of the afternoon and decreases during meals.
*Salivary disorders
Glossodynia can cause a dry mouth or an excess of saliva.
*Gustatory disorders
Primary glossodynia can alter the gustatory sense: bitterness, acidity, metallic taste…
*Anxiety disorders
Primary glossodynia often causes anxiety and/or depressive disorders.
*Other symptoms
-Discomfort in the lips, palate, and sometimes throat.
-Loss of taste.
-Swallowing problems.
Treatments:
-Treating secondary glossodynia consists of treating the cause.
-Unfortunately, the treatment for primary glossodynia is still unclear considering the uncertainty around the cause.
But, different options can alleviate the pain:
- Clonazepam: Reduces the burning sensation in 70% of the patients.
- Capsaicin: Applied 3 to 4 times a day on the tongue. It enables a partial or full recovery from the pain.
- Cognitive and behavioral therapies.
- Psychological support. Recognizing the disease helps alleviate the pain.
The use of anxiolytics and antidepressants are insufficient.
Prevention:
-Do not smoke.
-Avoid spicy or acidic foods.
-Reduce alcohol and fizzy beverages consumption.
-Do not use a mouthwash containing alcohol.
-Exercise regularly.
-Sleep well.
-Manage your stress: Rest, meditation, yoga…
