Burning Mouth Syndrome: It’s Not in Your Head – Understanding the True Causes

While many physicians tell you the cause of burning mouth is psychological, I know it’s not your head. What else have studies shown?

It’s not your head. What else have studies shown?

When Burning Mouth Syndrome researchers have done biopsies and looked at the tongues of people with burning mouth syndrome, the pain receptors and the nerve growth factors were different. So, brain derived neurotrophic factor (BDNF) a wonderful healing factor for nerves was lacking in burning mouth patients. When they did specialize stains, looking at the nerves in the tongue biopsy, they could see that the nerves were degenerated. The nerves didn’t look normal and other MRI brain imaging showed changes in the brain.

So, we don’t do biopsies in everybody with burning mouth. These are more, like research tools. The fact is these are showing us definite reasons for the pain.  That means something is going on, that’s not normal. Then this is a big clue who gets BMS. So, it’s estimated that anywhere from less than a percent to up to 15% of the population has Burning Mouth Syndrome. Different parts of the world and different studies report, different percentages of the population. We know that it tends to increase in frequency as people get older

Burning Mouth Syndrome affects women more than men

Burning Mouth Syndrome occurs far more in women than it does in men. Depending on the study that you look at, it’s anywhere from three women to every man who gets it up to 20 women to every man who gets burning mouth syndrome. Moreover, I have to say, I’ve seen far more women than men. I would say it’s probably in 10 or 20 ratio. A large percentage of women who have had their ovaries removed surgically have oral pain. They lose their hormones, and they have pain in their mouth. The average age of getting burning mouth syndrome for women is age 60. If men have it, they usually get it in an older age. It’s very unusual to see Burning Mouth Syndrome in women under age 30 or in men under age 40. In summary, it occurs later and less frequently for men.

90% of Burning Mouth Syndrome occurs in menopausal women

 This to me is the real clue to where things are. 90% of Burning Mouth Syndrome occurs in perimenopausal and menopausal women. Hormones play a role for sure. And rarely in women under 30 age 30, because you should be hormonally your optimal in life. Somewhere between age 25 and 30. Your hormones should be great. That’s not necessarily true in this modern day and age. We have toxins in the environment. We have stress. We don’t have the greatest food supply. So, we’re lacking some micronutrients. So, I would say people are not as optimized as they could be between age 25 and 30, but that’s when we are functioning hormonally at our best. And as time goes on, and especially with the changes in menopause, and we’ll talk about that. We see the rise of burning in the mouth.

There are lots of protective hormones protective against for your nerves and they decline with age. This is the list of them.

• Thyroid hormone
• Human growth hormone
• Testosterone
• Pregnenolone
• Melatonin
• Oxytocin
• Estrogen
• Progesterone

Testosterone in both men and women is our energy and vitality hormone. By the time you’re in your mid-forties, it’s half of what it was when you were in your late twenties. Pregnenolone is very nerve protective important for your memory. Melatonin goes down harder to go to sleep. Oxytocin, which is known as the cuddle hormone goes down as we get older. Then the other thing that happens with menopause is that we lose our estrogen and progesterone, which are hugely protective.

Stress damages nerves

The other thing that happens with age, everything’s going down, down, down or disappearing, except for cortisol our stress hormone. And it goes up with age and up with stress. And guess what? Cortisol damages nerves. We know that stress impacts the brain. We work a lot with patients with cognitive decline. Stress actually shrinks your brain by damaging nerves in your brain, and it can damage nerves anywhere in your body. We don’t know the original triggering cause of Burning Mouth Syndrome.  But we certainly know many of the factors that could make it better and can make it worse.

And we know stress plays a large role because going back to the initial patient, I told you about our fitness instructor. She got on her hormone restoration program. Her burning tongue was way better. A couple of years later, she had a divorce and with all the stress of the divorce, her burning tongue got worse again. So, we know that stress plays a role. Cortisol plays a role, in damaging nerves and allowing this process to happen again. In addition, I’ve seen that in more than one patient where their pain is greatly diminished. They are functioning pretty well. Then a very stressful event occurs and their pain comes back or increases. It doesn’t mean it’s forever. When stress, declines it gets better. We adjust their hormones. We work on stress reduction techniques. And we work on things that keep cortisol from doing as much damage as it does. There are supplements to do that. Usually the pain will generally diminish again.

The perfect storm

What you have in perimenopausal and menopausal women is what I call the perfect storm. There’s been some nerve damage. We don’t exactly know what the reason is. And that’s something that we’re still trying to figure out. There’s hormone decline and there’s psychological stress. And even if you don’t feel really stressed at menopause, what happens with your loss of estrogen is you lose a lot of your resilience. Estrogen is an incredible buffer and anti-inflammatory and diminishes your stress response physiologically. We see it in our patients who say, “You know, I used to be able to juggle so many things be so even tempered. I could handle anything. I went through menopause and now I can’t do it. I get stressed and I can’t handle it.” A lot of that is loss of estrogen. So, it’s a combination of things that go on that I think come together and result in Burning Mouth Syndrome. The next section is about treatment. I’m going to tell you about the things that are typically done. I’ll tell you about what I’ve seen work and not work. Then I’ll tell you about the innovative things that we’ve been using.