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The Strange Cause of Burning Mouth Syndrome Revealed in a Study

International Business Times
By: Rina Marie Garcia

A study recently reported that the cause of the burning mouth sensation of a woman has been discovered. After months of testing and consultations with different medical specialists, experts have finally pointed out the main cause of what used to be an inexplicable case of “burning mouth”.

The 65-year-old patient had been suffering from a burning feeling in her mouth that has stunned doctors, due to its unidentifiable aetiology. The sensation aggravated every time the woman brushed her teeth, but it disappeared within 10 minutes. The initial episode of the symptoms continued for one month but eventually subsided. After a year, the patient had to deal with the feeling once again as the same problem recurred and became persistent from then on.

She sought the advice of a dentist, an oral surgeon and her family doctor, but none of them was able to identify the reason behind her problem. The experts did not find any oral lesions that can possibly serve as a media for the burning sensation. Nonetheless, she received medical recommendations, such as using mouthwashes and milk-of magnesia solutions and even taking anti-anxiety medications, but to no avail.

The patient had a rare condition, called “Burning Mouth Syndrome,” which according to BMJ Case Reports is characterised by a chronic, burning feeling in the mouth, particularly in the lips, palate or tongue. “It’s common in postmenopausal women and affects up to seven percent of the general population,” states research co-author Dr Maria Nagel, a neurovirologist and professor at the University of Colorado School of Medicine in Aurora. She noted that Burning Mouth Syndrome can occur as a side effect of several drugs, but some cases develop without an apparent reason. She adds that the sensation is comparable to the pain caused by a tooth infection or a root canal procedure.

Part of the clinical investigation of the medical experts involved in the care of the patient is the testing of her saliva for herpes simplex virus type 1 (HSV-1). HSV-1 is the viral agent that causes oral herpes, which is usually manifested by cold sores around the buccal cavity. Although the woman did not have cold sores, the medical team decided to perform the test after six month of persistent symptoms.

After the results of the test was released, it was discovered that the saliva of the patient had high levels of HSV-1. “If she’d had cold sores, it would have been obvious,” Nagel told Live Science. “Most people don’t think of HSV-1 as the potential cause of burning mouth syndrome, so they don’t test for it. But it’s easily treatable with antiviral medication,” she adds.

The woman was then prescribed to undergo an antiviral drug therapy. Five days into the treatment, and the woman’s symptoms subsided. Follow-up procedures were performed four weeks and six months after the treatment to test for the presence of the virus in the saliva. The researchers found no trace of the HSV-1 and after completing the prescribed antiviral treatment for one and a half year, the woman had not experience the burning sensation again. The research team, however, had not identified the exact reason as to why HSV-1 had reactivated in this woman, but they suspected that it is likely due to hormonal imbalances associated with the postmenopausal stage.

HSV-1 affects about 70 percent of the worldwide population and according to the Centres for Disease Control and Prevention (CDC), the virus is transmitted via kissing and sharing of personal items such as toothbrushes and towels. HSV-1 is most commonly activated when the person is stressed or has a weak immune system and manifests through self-limiting cold sores. However, some cases of viral reactivation that does not cause cold sores had been reported — an example of which is this woman’s. Nagel further explains that although some cases of HSV-1 reactivation does not cause cold sores, it can manifest as a facial nerve affectation, particularly causing impairments in the trigeminal ganglion, which regulates the the sensation of the face and mouth.

Other medical conditions with no clear aetiology may also be associated with HSV-1. Nagel cites their latest discovery as an example; their team recently discovered that HSV-1 can also cause migraine headaches and that some patients were relieved from taking antiviral drugs. Additionally, a report from Mayo Clinic also said that HSV-1 can also cause a fatal brain inflammation called encephalitis.