Burning Mouth Syndrome

A woman who revealed how she developed burning mouth syndrome after major dental work is far from alone - even though some medical experts have dismissed the connection. She developed a painful sensation in her mouth after having a dental bridge fitted. Understandably, she believed the two events to be linked. However, a number of doctors and dentists disagreed, suggesting the problem was, in fact, psychological.

Many people report their symptoms had also started after major dental work, although most had found doctors and dentists were unable to help. Yet according to oral and maxillofacial surgeon Dr Carrie Newlands, who sees three patients with BMS each week at her clinic at the Royal Surrey County Hospital, Guildford, the majority of cases are unconnected to fillings, crowns or bridges.

Despite being a common condition, no one has come up with a satisfactory explanation. Some doctors find it hard to accept conditions which are not fully understood and they don't know how to treat. This could explain why GPs are dismissive.'

BMS is diagnosed only when all other possible causes for symptoms have been ruled out.

When a patient complains of these symptoms blood tests for iron and Vitamin B12 deficiency, as these can affect the skin inside the mouth or irritate the nerves, leading to a burning sensation. Common practice is swabbing for a thrush type fungal infection which may not be obvious to the eye. Cancer and neurological diseases are also tested for. Nine out of ten cases are negative. In these instances the diagnosis is burning mouth syndrome.

But what are the treatment options? In failing to understand the underlying causes the patient is often diagnosed with depression.

In the same way aspirin is used for headaches and as a blood thinner, antidepressants have more than one use. Antidepressants can be helpful helpful in treating BMS by interfering with the way the nerves send pain messages, but does this address the underlying cause? Cognitive behavioural therapy, a kind of psychological intervention, can help. This teaches patients to stop focusing on the symptoms. It is assumed that around half of all patients get better without any kind of medical treatment, possibly because they find they are up against a brick wall of entrenched attitudes and stop going back to their GP.

Here are just a few of the letters received in a Daily Mail campaign to get recongition for a possible cause being dental work (names and addresses have been withheld as the letters contain personal medical details):

At last! An article that describes my symptoms exactly. Three years ago I had a bridge fitted to my top front teeth. Within months I experienced a burning sensation in my palate. This has never gone away. I have had every test imaginable, from mouth swabs testing for thrush to MRI scans, all to no avail. During all this time I have been faced with blank looks whenever I have described my symptoms to the medics.

Three cheers for The Mail on Sunday for highlighting Astrid Wilson's problem. I had bridge work done about three years ago and have suffered the same symptoms. My doctor said he couldn't help. So I've had to learn to live with it. I have resorted to using Bonjela which numbs the pain before I go to sleep. There is not a lot of either help or sympathy, as it's not life-threatening.

My mother had BMS for nearly two years. We took her to the dentist who referred her to the maxillofacial unit at hospital. They sent her to another hospital for allergy testing. No allergies were detected so as a last resort the consultant prescribed Amitriptyline [an antidepressant] to be taken at night. She has not had any problems since.

I am 63 and in 2004 had a bridge fitted. I chipped it but this did not pose any problems so it was left. By early 2007 I was going to the doctor and dentist complaining of burning sensations in my mouth along with odd metallic tastes and constant headaches. I was prescribed mouthwashes and pain killers and had blood tests. Then I had a brain scan to rule out tumours. With all the results coming in negative I felt like the batty menopausal woman with an over-active imagination. Should I now go back to my GP and ask to be tested for palladium?

I am 63 and in quite good health. I had the same thing when I had a filling two years ago. The dentist sent me to see a consultant who said to suck a boiled sweet! Not much help there, so I have just got to live with it. At least I know I am not the only one.

My GP had never heard of BMS. He suggested I avoid antiseptic mouthwash. My own strategy is to chew gum as this is often the only way I can get through the day. My theory is that the cause is a filling I had shortly before the condition began eight months ago.

I have suffered for five years and although my dentist says there is no connection it did start after I had crown work done. I have researched as much as I can but would like to know how many sufferers also have reflux. This has bothered me for years but it is only now when at the hospital for an endoscopy that a consultant suggested there could be a connection.

I have had a similar problem with the side of my tongue for 10 years. I read that low levels of antidepressants may ease the problem. I obtained a prescription from my doctor but this didn't improve the situation.

The worst thing with BMS is lack of sleep. A broken night - every night for three years. You start to feel not human. I am not suffering from psychological problems or any recent dental work.

I had bridge work carried out and my dentist has categorically stated this was not the cause. I am a 60-year-old male and certainly not menopausal but I have suffered some depression since 2005. I would love some good advice as to how to get over this, even if it means replacing my bridge.

Under new EU regulations the use of mercury in 'silver'amalgam filling (the ones that eventually turn black) will shortly be banned in all EU countries. It is already not used in dental work in many other EU countries but for some unknow reason the UK lags behind.