Oral Burning Sensation: Causes and Solutions

Q: Oral Burning Sensation: Causes and Solutions

Hello Mr. <br>Hsiao： Oral ulcers typically heal on their own and are often accompanied by a burning sensation. <br>They are usually caused by factors such as excessive stress, lack of sleep, or individual constitution. <br>Generally, improving your condition can be achieved by ge

Burning mouth syndrome

Doctor, I often experience a burning sensation in my mouth, specifically on the right side of the base of my tongue, the gums of the upper right molars, and the middle of my tongue.
This sensation is less intense when I first wake up, but it gradually increases after about an hour.
The affected areas vary daily but generally include the aforementioned locations.
This has been ongoing for about four months.
Occasionally, I have 1 to 2 small ulcers in my mouth, but they heal within a few days.
When I press the left side of my tongue against the floor of my mouth, I can feel a small bump that resembles a blister (this has been present for about two weeks), but it looks normal and does not protrude.
I have consulted both an oral specialist and an ENT specialist, and they both said there seems to be no issue.
However, the ENT doctor mentioned the possibility of cancer and recommended that I pay out of pocket for an MRI of my head, which is quite expensive.
What tests should I consider? Occasionally, I experience esophageal symptoms, but my eating habits are normal.
Six months ago, I was worried about HIV due to significant stress, but after three tests at a military hospital three months later, all were negative, confirming that I do not have HIV.
I also had a normal PCR test.
My condition has gradually improved, but I still experience a burning sensation daily, although it is not as severe.
Recently, I have been prone to mouth ulcers, but they heal quickly, usually within a few days.
I am quite troubled by these symptoms.
The burning sensation predominantly occurs in the upper right gum area, while my cheeks do not experience this issue.
Additionally, I sometimes have mild diarrhea, with soft stools occurring about once a week, and I typically have a bowel movement every two days.

Xiao Zhang, 30~39 year old female. Ask Date: 2005/11/21

Dr. Hu Kexin reply Otolaryngology

Hello Mr.
Hsiao: Oral ulcers typically heal on their own and are often accompanied by a burning sensation.
They are usually caused by factors such as excessive stress, lack of sleep, or individual constitution.
Generally, improving your condition can be achieved by getting plenty of rest, ensuring adequate sleep, increasing your intake of fruits and vegetables, and relaxing your mind.
As for the blister-like lesion you mentioned at the floor of your mouth, it is too abstract to describe in words, so I recommend that you visit a hospital for a proper examination.
Wishing you good health.

Reply Date: 2005/11/21

More Info

The sensation of burning in the mouth, often referred to as burning mouth syndrome (BMS), can be a perplexing and distressing condition. Your description of the burning sensation localized to specific areas of your mouth, particularly the right side of the tongue and gums, along with the occurrence of occasional ulcers, suggests a multifactorial issue that may require further evaluation.

Possible Causes of Oral Burning Sensation
1. Burning Mouth Syndrome (BMS): This condition is characterized by a burning sensation in the mouth without an obvious cause. It often worsens throughout the day and can be accompanied by dry mouth, altered taste, or a metallic taste. Stress, anxiety, hormonal changes, and certain medications can exacerbate BMS.

2. Oral Ulcers: The presence of ulcers can contribute to a burning sensation. These can be caused by various factors, including stress, dietary deficiencies (such as vitamin B12, folate, or iron), or local trauma (like biting the cheek or tongue).

3. Oral Candidiasis: A fungal infection in the mouth can lead to discomfort and burning sensations. This is more common in individuals with weakened immune systems or those who use inhaled corticosteroids.

4. Nutritional Deficiencies: Deficiencies in vitamins, particularly B vitamins, can lead to symptoms like burning sensations in the mouth. A balanced diet rich in fruits, vegetables, and whole grains is essential for oral health.

5. Gastroesophageal Reflux Disease (GERD): If you experience symptoms like a burning sensation in the throat or esophagus, it could be related to acid reflux, which can also cause irritation in the oral cavity.

6. Psychological Factors: Anxiety and stress can manifest physically, leading to symptoms like burning mouth. Your previous concerns about HIV and the resultant stress may have contributed to your current symptoms.

Recommendations for Management
1. Consultation with Specialists: Since you have already seen an oral specialist and an ENT doctor, consider a follow-up visit to a dentist who specializes in oral medicine or a neurologist if the symptoms persist. They may conduct further tests to rule out systemic conditions.

2. Nutritional Assessment: A comprehensive evaluation of your diet may be beneficial. If deficiencies are suspected, consider supplementation or dietary adjustments.

3. Stress Management: Techniques such as mindfulness, yoga, or counseling may help alleviate stress-related symptoms. Addressing anxiety can significantly improve your overall well-being.

4. Oral Hygiene: Maintain good oral hygiene by brushing gently with a soft-bristled toothbrush and using alcohol-free mouthwashes. This can help reduce irritation.

5. Avoid Irritants: Stay away from spicy, acidic, or hot foods that may exacerbate the burning sensation. Staying hydrated is also crucial.

6. Medications: If the burning sensation is severe, your doctor may prescribe medications to help manage the symptoms. Some patients benefit from topical anesthetics or medications that address nerve pain.

7. Monitoring Symptoms: Keep a diary of your symptoms, noting any triggers or patterns. This can provide valuable information for your healthcare provider.

Conclusion
While the burning sensation in your mouth can be distressing, it is essential to approach it holistically. By addressing potential nutritional deficiencies, managing stress, and consulting with appropriate specialists, you can work towards alleviating your symptoms. If your condition does not improve or worsens, further diagnostic testing, including imaging studies, may be warranted to rule out any underlying conditions. Remember, open communication with your healthcare providers is key to finding an effective management plan tailored to your needs.

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