Which drugs may be etiologic factors in burning mouth syndrome (BMS)?

Answer

Various cases of drug-associated burning mouth syndrome (BMS) have been reported. ACE inhibitors and angiotensin receptor blockers are perhaps the most commonly noted in case reports.^{[39, 40, 41]}This may be the product of an inflammatory reaction generated by increases in bradykinin (similar to the mechanism by which angioedema may result). The mechanism as it relates to burning mouth symptoms has not been determined, but kallikrein, a molecule active in the kinin pathway, may be increased in the saliva of burning mouth syndrome (BMS) patients, resulting in increased inflammation.^[16]

Other drugs that have been reported are the antiretrovirals nevirapine and efavirenz.^{[42, 43]}No clear mechanism has been proposed. L-thyroxines have also been implicated in burning mouth syndrome (BMS), although whether the medication itself or the underlying hypothyroidism is the cause is unclear.^[44]Topirimate, a common treatment for trigeminal neuralgia, has been reported to cause BMS-like symptoms.^[18]

Source Article: Burning Mouth Syndrome: Proposed Etiologies

Did this answer your question?

Yes No

Additional feedback? (Optional)

Thank you for your feedback!

Gurvits GE, Tan A. Burning mouth syndrome. World J Gastroenterol. 2013 Feb 7. 19 (5):665-72. [Medline]. [Full Text].
Feller L, Fourie J, Bouckaert M, Khammissa RAG, Ballyram R, Lemmer J. Burning Mouth Syndrome: Aetiopathogenesis and Principles of Management. Pain Res Manag. 2017. 2017:1926269. [Medline]. [Full Text].
Coculescu EC, Radu A, Coculescu BI. Burning mouth syndrome: a review on diagnosis and treatment. J Med Life. 2014 Oct-Dec. 7 (4):512-5. [Medline]. [Full Text].
Coculescu EC, Tovaru S, Coculescu BI. Epidemiological and etiological aspects of burning mouth syndrome. J Med Life. 2014 Sep 15. 7 (3):305-9. [Medline]. [Full Text].
Tait RC, Ferguson M, Herndon CM. Chronic Orofacial Pain: Burning Mouth Syndrome and Other Neuropathic Disorders. J Pain Manag Med. 2017 Mar. 3 (1):[Medline]. [Full Text].
Huang W, Rothe MJ, Grant-Kels JM. The burning mouth syndrome. J Am Acad Dermatol. 1996 Jan. 34(1):91-8. [Medline].
Forssell H, Jaaskelainen S, Tenovuo O, et al. Sensory dysfunction in burning mouth syndrome. Pain. 2002 Sep. 99(1-2):41-7. [Medline].
Grushka M, Sessle BJ, Howley TP. Psychophysical assessment of tactile, pain and thermal sensory functions in burning mouth syndrome. Pain. 1987 Feb. 28(2):169-84. [Medline].
Beneng K, Yilmaz Z, Yiangou Y, McParland H, Anand P, Renton T. Sensory purinergic receptor P2X(3) is elevated in burning mouth syndrome. Int J Oral Maxillofac Surg. 2010 Apr 24. [Medline].
Matsuoka H, Himachi M, Furukawa H, Kobayashi S, Shoki H, Motoya R, et al. Cognitive profile of patients with burning mouth syndrome in the Japanese population. Odontology. 2010 Jul. 98(2):160-4. [Medline].
Galli F, Lodi G, Sardella A, Vegni E. Role of psychological factors in burning mouth syndrome: A systematic review and meta-analysis. Cephalalgia. 2016 Apr 27. [Medline].
Mo X, Zhang J, Fan Y, Svensson P, Wang K. Thermal and mechanical quantitative sensory testing in Chinese patients with burning mouth syndrome--a probable neuropathic pain condition?. J Headache Pain. 2015. 16:84. [Medline]. [Full Text].
Eliav E, Kamran B, Schaham R, et al. Evidence of chorda tympani dysfunction in patients with burning mouth syndrome. J Am Dent Assoc. 2007 May. 138(5):628-33. [Medline].
Lauria G, Majorana A, Borgna M, et al. Trigeminal small-fiber sensory neuropathy causes burning mouth syndrome. Pain. 2005 Jun. 115(3):332-7. [Medline].
Yilmaz Z, Renton T, Yiangou Y, et al. Burning mouth syndrome as a trigeminal small fibre neuropathy: Increased heat and capsaicin receptor TRPV1 in nerve fibres correlates with pain score. J Clin Neurosci. 2007 Sep. 14(9):864-71. [Medline].
Loeb LM, Naffah-Mazzacoratti MG, Porcionatto MA, et al. Chondroitin sulfate and kallikrein in saliva: Markers for glossodynia. International Immunopharmacology. July 2008. 8:1056-1058. [Medline].
de Moura SA, de Sousa JM, Lima DF, et al. Burning mouth syndrome (BMS): sialometric and sialochemical analysis and salivary protein profile. Gerodontology. 2007 Sep. 24(3):173-6. [Medline].
Friedman DI. Topirimate-Induced Burning Mouth Syndrome. Headache. 2010 Jun 18. [Medline].
Moisset X, Calbacho V, Torres P, Gremeau-Richard C, Dallel R. Co-occurrence of Pain Symptoms and Somatosensory Sensitivity in Burning Mouth Syndrome: A Systematic Review. PLoS One. 2016 Sep 22. 11 (9):e0163449. [Medline].
Bergdahl M, Bergdahl J. Burning mouth syndrome: prevalence and associated factors. J Oral Pathol Med. 1999 Sep. 28(8):350-4. [Medline].
Scala A, Checchi L, Montevecchi M, et al. Update on burning mouth syndrome: overview and patient management. Crit Rev Oral Biol Med. 2003. 14(4):275-91. [Medline].
Klasser GD, Epstein JB, Villines D. Diagnostic dilemma: the enigma of an oral burning sensation. J Can Dent Assoc. 2011 Dec. 77:b146. [Medline].
Netto FO, Diniz IM, Grossmann SM, de Abreu MH, do Carmo MA, Aguiar MC. Risk factors in burning mouth syndrome: a case-control study based on patient records. Clin Oral Investig. 2010 May 4. [Medline].
Sardella A, Lodi G, Demarosi F, et al. Causative or precipitating aspects of burning mouth syndrome: a case-control study. J Oral Pathol Med. 2006 Sep. 35(8):466-71. [Medline].
Paterson AJ, Lamb AB, Clifford TJ, et al. Burning mouth syndrome: the relationship between the HAD scale and parafunctional habits. J Oral Pathol Med. 1995 Aug. 24(7):289-92. [Medline].
Adamo D, Sardella A, Varoni E, et al. The association between burning mouth syndrome and sleep disturbance: a case-control multicentre study. Oral Dis. 2017 Nov 20. [Medline].
Mínguez Serra MP, Salort Llorca C, Silvestre Donat FJ. Pharmacological treatment of burning mouth syndrome: A review and update. Med Oral Patol Oral Cir Bucal. 2007 Aug 1. 12(4):E299-304. [Medline].
Välimaa H, Savolainen S, Soukka T, et al. Estrogen receptor-beta is the predominant estrogen receptor subtype in human oral epithelium and salivary glands. J Endocrinol. 2004 Jan. 180(1):55-62. [Medline].
Moore PA, Guggenheimer J, Orchard T. Burning mouth syndrome and peripheral neuropathy in patients with type 1 diabetes mellitus. J Diabetes Complications. 2007 Nov-Dec. 21(6):397-402. [Medline].
Grushka M. Clinical features of burning mouth syndrome. Oral Surg Oral Med Oral Pathol. 1987 Jan. 63(1):30-6. [Medline].
Granot M, Nagler RM. Association between regional idiopathic neuropathy and salivary involvement as the possible mechanism for oral sensory complaints. J Pain. 2005 Sep. 6(9):581-7. [Medline].
Koike M. [A case of burning mouth associated with dental metal allergy]. Nihon Hotetsu Shika Gakkai Zasshi. 2005 Jun. 49(3):498-501. [Medline].
Cho GS, Han MW, Lee B, Roh JL, Choi SH, Cho KJ, et al. Zinc deficiency may be a cause of burning mouth syndrome as zinc replacement therapy has therapeutic effects. J Oral Pathol Med. 2010 Jul 2. [Medline].
Amenabar JM, Pawlowski J, Hilgert JB, et al. Anxiety and salivary cortisol levels in patients with burning mouth syndrome: case-control study. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics. April/2008. 105:461-465. [Medline].
Lamey PJ, Lamb AB. Prospective study of aetiological factors in burning mouth syndrome. Br Med J (Clin Res Ed). 1988 Apr 30. 296(6631):1243-6. [Medline].
Barry A, O'Halloran KD, McKenna JP, McCreary C, Downer EJ. Plasma IL-8 signature correlates with pain and depressive symptomatology in patients with burning mouth syndrome: Results from a pilot study. J Oral Pathol Med. 2017 Dec 1. [Medline].
Jaaskelainen SK, Rinne JO, Forssell H, et al. Role of the dopaminergic system in chronic pain -- a fluorodopa-PET study. Pain. 2001 Feb 15. 90(3):257-60. [Medline].
Terai H, Shimahara M. Glossodynia from Candida-associated lesions, burning mouth syndrome, or mixed causes. Pain Med. 2010 Jun. 11(6):856-60. [Medline].
Castells X, Rodoreda I, Pedros C, et al. Drug points: Dysgeusia and burning mouth syndrome by eprosartan. BMJ. 2002 Nov 30. 325(7375):1277. [Medline].
Triantos D, Kanakis P. Stomatodynia (burning mouth) as a complication of enalapril therapy. Oral Dis. 2004 Jul. 10(4):244-5. [Medline].
Savino LB, Haushalter NM. Lisinopril-induced "scalded mouth syndrome". Ann Pharmacother. 1992 Nov. 26(11):1381-2. [Medline].
Moura MD, Senna MI, Madureira DF, et al. Oral adverse effects due to the use of Nevirapine. J Contemp Dent Pract. 2008 Jan 1. 9(1):84-90. [Medline].
Borras-Blasco J, Belda A, Rosique-Robles JD, et al. Burning mouth syndrome due to efavirenz therapy. Ann Pharmacother. 2006 Jul-Aug. 40(7-8):1471-2. [Medline].
Femiano F, Lanza A, Buonaiuto C, et al. Burning mouth syndrome and burning mouth in hypothyroidism: proposal for a diagnostic and therapeutic protocol. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics. January/2008. 105:E22-27. [Medline].
Svensson P, Kaaber S. General health factors and denture function in patients with burning mouth syndrome and matched control subjects. Journal of Oral Rehabilitation. December/1995. 22:887-895. [Medline].
Lynde CB, Grushka M, Walsh SR. Burning mouth syndrome: patch test results from a large case series. J Cutan Med Surg. 2014 May-Jun. 18(3):174-9. [Medline].
Acharya S, Carlen A, Wenneberg B, Jontell M, Hagglin C. Clinical characterization of women with burning mouth syndrome in a case-control study. Acta Odontol Scand. 2017 Dec 28. 1-8. [Medline].
Culhane NS, Hodle AD. Burning mouth syndrome after taking clonazepam. Ann Pharmacother. 2001 Jul-Aug. 35(7-8):874-6. [Medline].
Heir GM. Ciguatera neurotoxin poisoning mimicking burning mouth syndrome. Quintessence Int. 2005 Jul-Aug. 36(7-8):547-50. [Medline].
Parmar G, Sangwan P, Vashi P, et al. Effect of chewing a mixture of areca nut and tobacco on periodontal tissues and oral hygiene status. Journal of Oral Science. March/2008. 50:57-62. [Medline].
Ozkan BT, Celik S, Durmus E. Paresthesia of the mental nerve stem from periapical infection of mandibular canine tooth: a case report. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics. May/2008. 105:e28-31. [Medline].
Fischoff DK, Spivakovsky S. Little evidence to support or refute interventions for the management of burning mouth syndrome. Evid Based Dent. 2017 Jun 23. 18 (2):57-8. [Medline].
de Moraes M, do Amaral Bezerra BA, da Rocha Neto PC, de Oliveira Soares AC, Pinto LP, de Lisboa Lopes Costa A. Randomized trials for the treatment of burning mouth syndrome: an evidence-based review of the literature. J Oral Pathol Med. 2011 Nov 18. [Medline].
Ni Riordain R, Moloney E, O'Sullivan K, McCreary C. Burning mouth syndrome and oral health-related quality of life: is there a change over time?. Oral Dis. 2010 Apr 19. [Medline].
Sardella A, Lodi G, Demarosi F, et al. Burning mouth syndrome: a retrospective study investigating spontaneous remission and response to treatments. Oral Dis. 2006 Mar. 12(2):152-5. [Medline].
Mínguez Serra, MP. Pharmacological treatment of burning mouth syndrome: A review and update. Medicina oral, patología oral y cirugía bucal. August/2007. 12:E299-304. [Medline].
Patton LL, Siegel MA, Benoliel R, et al. Management of burning mouth syndrome: systematic review and management recommendations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Mar. 103 Suppl:S39.e1-13. [Medline].
Kuten-Shorrer M, Treister NS, Stock S, et al. Topical Clonazepam Solution for the Management of Burning Mouth Syndrome: A Retrospective Study. J Oral Facial Pain Headache. 2017 Summer. 31 (3):257-63. [Medline].
Petruzzi M, Lauritano D, De Benedittis M, et al. Systemic capsaicin for burning mouth syndrome: short-term results of a pilot study. J Oral Pathol Med. 2004 Feb. 33(2):111-4. [Medline].
Azzi L, Croveri F, Pasina L, et al. A burning therapy for burning mouth syndrome: preliminary results with the administration of topical capsaicin. J Biol Regul Homeost Agents. 2017 Apr-Jun. 31 (2 Suppl 1):89-95. [Medline].
Nakase M, Okumura K, Tamura T, et al. Effects of near-infrared irradiation to stellate ganglion in glossodynia. Oral Dis. 2004 Jul. 10(4):217-20. [Medline].
Siniscalchi A, Gallelli L, Marigliano NM, et al. Use of topiramate for glossodynia. Pain Med. 2007 Sep. 8(6):531-4. [Medline].
Gick CL, Mirowski GW, Kennedy JS, et al. Treatment of glossodynia with olanzapine. J Am Acad Dermatol. 2004 Sep. 51(3):463-5. [Medline].
Scardina GA, Ruggieri A, Provenzano F, Messina P. Burning mouth syndrome: is acupuncture a therapeutic possibility?. Br Dent J. 2010 Jul 10. 209(1):E2. [Medline].
Franco FR, Castro LA, Borsatto MC, Silveira EA, Ribeiro-Rotta RF. Combined Acupuncture and Auriculotherapy in Burning Mouth Syndrome Treatment: A Preliminary Single-Arm Clinical Trial. J Altern Complement Med. 2016 Sep 1. [Medline].
Miziara I, Chagury A, Vargas C, Freitas L, Mahmoud A. Therapeutic options in idiopathic burning mouth syndrome: literature review. Int Arch Otorhinolaryngol. 2015 Jan. 19 (1):86-9. [Medline].
Al-Maweri SA, Javed F, Kalakonda B, AlAizari NA, Al-Soneidar W, Al-Akwa A. Efficacy of Low Level Laser Therapy in the Treatment of Burning Mouth Syndrome: A Systematic Review. Photodiagnosis Photodyn Ther. 2016 Dec 2. [Medline].
de Souza FT, Amaral TM, Dos Santos TP, Abdo EN, Aguiar MC, Teixeira AL, et al. Burning Mouth Syndrome: A Therapeutic Approach Involving Mechanical Salivary Stimulation. Headache. 2011 Nov 15. [Medline].

Media Gallery

A 29-year-old female presents with tongue irritation. A diagnosis of benign migratory glossitis (geographic tongue) is made by the appearance. The portions of the tongue with atrophic filiform papilla are symptomatic to acidic foods.
A 60-year-old male with a 2-week history of tongue and mouth burning. The lateral tongue was positive for C. albicans fungus inflammation. The black arrow identifies a white tongue lesion. The patient was treated with oral clotrimazole.
A 63-year-old female presents with tongue discomfort lasting 6 months. She had a right tongue squamous cell carcinoma that extended to the regional lymphatics. She was treated with combined modality therapy.
A 55-year-old female with tongue burning for 15 months. The history for cancer risk factors was negative. Examination failed to reveal any systemic or local causes. Diagnosis of burning mouth syndrome (BMS) was made, and the patient received no medical treatment except for serial examinations.

of 4

Author

Vincent D Eusterman, MD, DDS Assistant Professor, Director, Department of Otolaryngology-Head and Neck Surgery, Denver Health Medical Center

Vincent D Eusterman, MD, DDS is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Dental Association, American Head and Neck Society, American Medical Association, Society of University Otolaryngologists-Head and Neck Surgeons

Disclosure: Nothing to disclose.

Coauthor(s)

Katharine G Meddles, MD Pediatric Neurologist, UCSF Benioff Children's Hospital Oakland

Katharine G Meddles, MD is a member of the following medical societies: American Academy of Neurology, Child Neurology Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Robert M Kellman, MD Professor and Chair, Department of Otolaryngology and Communication Sciences, State University of New York Upstate Medical University

Robert M Kellman, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Head and Neck Society, American Rhinologic Society, Triological Society, American Neurotology Society, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, Medical Society of the State of New York

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan;RxRevu;Cliexa;Preacute Population Health Management;The Physicians Edge<br/>Received income in an amount equal to or greater than $250 from: The Physicians Edge, Cliexa<br/> Received stock from RxRevu; Received ownership interest from Cerescan for consulting; for: Rxblockchain;Bridge Health.

Additional Contributors

B Viswanatha, DO, MBBS, PhD, MS, FACS, FRCS(Glasg) Professor of Otolaryngology (ENT), Sri Venkateshwara ENT Institute, Victoria Hospital, Bangalore Medical College and Research Institute, India

B Viswanatha, DO, MBBS, PhD, MS, FACS, FRCS(Glasg) is a member of the following medical societies: Association of Otolaryngologists of India, Indian Medical Association, Indian Society of Otology

Disclosure: Nothing to disclose.

Which drugs may be etiologic factors in burning mouth syndrome (BMS)?

Answer

Related Questions:

About

Membership

Apps

WebMD Network

Editions

What to Read Next on Medscape

Which drugs may be etiologic factors in burning mouth syndrome (BMS)?

Answer

Related Questions:

References

Tables

Contributor Information and Disclosures

What would you like to print?

Find Us On

About

Membership

Apps

WebMD Network

Editions

What to Read Next on Medscape

Medscape Consult

Tools

Most Popular Articles