Oral Burning

Intraoral burning has been attributed to a number of different conditions and deficiency states. Other possible causes include: xerostomia (dry mouth); dentures; deficiencies of iron, vitamin B12, folic acid, vitamin B6, and protein; steatorrhea; antibiotic use; changes in mucosal innervation; and anxiety states. In non-denture wearers who are without teeth, nutritional disorders are the most common causative factors.

Some diabetics complain of dysesthia, a continuous oral burning sensation, usually involving the tip and dorsum of the tongue or the palate, and other underlying mucosal disorders, such as lichen planus and candidiasis (thrush).Ā  Oral burning sensations may indicate a vitamin B12 and/or zinc deficiency. Supplementing with vitamin B12 and zinc can rule this out. Laboratory tests can also determine if vitamin B12 and zinc deficiencies exist. Oral burning in the absence of physical and biochemical changes can represent diabetes-related oral sensory neuropathy. Symptoms of burning mouth can be improved using neuropathic analgesic medications: tricyclic antidepressants or clonazepam. A side effect of neuropathic analgesics is xerostomia (dry mouth), thus compounding already existing saliva alterations and increasing the risk for candidiasis and dental caries.

Nutritional deficiencies and oral health consequences that occur from disease or their drug consequences include altered taste and smell, reduced appetite, mouth dryness (xerostomia) and/or stomatitis. Numerous prescription and over-the-counter medications trigger oral conditions that induce vitamin or nutrient deficiencies. Proposed mechanisms of action are general systemic effects, identifiable unpleasant oral consequences and limited direct oral mucosal contact, subsequently reducing appetite and food intake, and adversely affecting nutritional status. Clinical manifestations of adverse drug-nutrient interactions depend on recognizing the appearance of adverse manifestations. Careful oral cavity monitoring for signs of drug/nutrient/vitamin deficiencies (e.g., atrophic glossitis), can allow intervention before nutritional status is further compromised. Optimal oral health can help minimize some adverse events that impair food intake and nutritional status.

Zinc depletion can cause slowed wound healing, loss of sense of taste and smell, and lowered immunity. Zinc is a known immune stimulant. Zinc deficiency in humans is widespread. Experimental and clinical studies indicate that zinc deficiency can predispose individuals to glucose intolerance, diabetes mellitus, insulin resistance, atherosclerosis, and coronary artery disease. Zinc deficiency also leads to hypogeusia in humans and rats. Symptoms of hypogeusia can be reversed by administration of zinc. Human and animal studies report inverse relationships between low dietary zinc and intake of low nutrient-dense foods and patterns of food selection.