FAMILY MEDICINE® COLUMN

By Martha A. Simpson, D.O., M.B.A.
Assistant Professor of Family Medicine
Ohio University College of Osteopathic Medicine

BURNING MOUTH MAY BE TREATABLE, BUT OFTEN NOT CURABLE

Question: I have recently been scouring the internet to help my mother, who has suffered from a sore and painful throat for some time now. She also suffers from a burning mouth. I have two questions: Are these related? And, what treatment is available?

Answer: A painful, sore throat along with a burning mouth is a “symptom constellation” that’s becoming more common in older adults. It is often not possible, unfortunately, to cure this disorder. We simply treat the symptoms and help the patient learn to live with the disorder. This may, indeed, be the situation in your mother’s case.

Inflammation of the mouth and its structures is called stomatitis. Xerostomia is the medical term for dry mouth. The symptoms of each may be very similar. They may exist at the same time, and they may be caused by many of the same conditions. Ultimately, it will be up to your mother’s physician or dentist to differentiate which condition is her primary problem.

The symptoms of stomatitis are usually a painful mouth with redness and swelling of the affected part. Bad breath is common. Xerostomia (dry mouth) is frequently associated with a burning sensation in the mouth and tongue, a constant sore throat and frequently bad breath. This causes excessive thirst, sometimes difficulty eating dry foods, difficulty swallowing and sores in the mouth.

Primary causes of dry mouth and stomatitis can be poor oral hygiene or poorly fitting dentures. Smoking can cause a chemical stomatitis leading to a painful, burning mouth. A dry, painful mouth is also a common side effect of chemotherapy. Many common viral illnesses, such as colds, flu and fevers, are associated with a dry mouth, but these usually last less than two weeks and get better as the patient gets better.

One of the most common causes of dry mouth is medication -- both prescription and over-the-counter. Some common culprits are medicines for blood pressure and sinus congestion as well as diuretics. To arrive at a diagnosis, your mother’s physician may start by asking her to stop all non-prescription drugs and to evaluate the side-effect profile of each of her prescription medications.

Systemic diseases can have dry mouth as an early symptom. These include autoimmune disorders, immune deficiency conditions and diabetes. Bacterial and viral infections of the mouth may also be associated with a dry, painful mouth. That’s why it’s important that your mother see a physician for a complete evaluation of her condition. Other causes of dry mouth include poor nutrition (especially vitamin B and folic acid deficiencies), anemia (low blood count), and panic disorders.

So, what should your mother do while she and her physician are getting to the cause? If she smokes, STOP. She should get a dental check up and start practicing good oral hygiene, including frequent brushing -- with a soft toothbrush -- and daily flossing. Also, she should avoid harsh mouthwashes, eat a balanced diet, take a multivitamin with B complex and trace elements, and avoid foods that are either very hot or very cold, although cold foods may be soothing. Foods that are sharp (like potato chips), sticky, dry, or highly spiced should be avoided. Its better to eat puddings, sorbet, and soft foods like mashed potatoes, cooked vegetables, soft cheeses and pastas. Using a straw can bypass a tender mouth. Sometimes your physician might recommend baby food, puréed foods or even liquid supplements.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701. Past columns are available online at http://www.FamilyMedicineNews.org.