Tuesday, June 26, 2012

Burning Mouth Syndrome

Burning mouth syndrome (BMS) is a complex, vexing condition in which a burning pain occurs that may involve your tongue, lips or widespread areas of your whole mouth, without any obvious reason.

The disorder has long been associated with a variety of other conditions — including menopause, psychological problems, nutritional deficiencies and disorders of the mouth, such as oral thrush and dry mouth (xerostomia). Some researchers have suggested dysfunctional or damaged nerves as a possible cause. But the exact cause of burning mouth syndrome is often difficult to pin down, and pain may continue for months or years.

Treatment of burning mouth syndrome is highly individualized and depends on your particular signs and symptoms and on the underlying cause or causes, if they can be identified. Most people with burning mouth syndrome can control their symptoms through tailored treatment plans.

Other names sometimes used for burning mouth syndrome include scalded mouth syndrome, burning tongue syndrome, burning lips syndrome, glossodynia and stomatodynia.

Signs and symptoms

Photographs showing burning mouth syndrome Click for images of burning mouth syndrome
The main symptom of burning mouth syndrome is a burning sensation involving your tongue, lips, gums, palate, throat or widespread areas of your whole mouth. People with the syndrome may describe the sensation in the affected areas as hot or scalded, as if they had been burned with a hot liquid.
Other symptoms may include:
  • Dry mouth
  • Sore mouth
  • A tingling or numb sensation in your mouth or on the tip of your tongue
  • A bitter or metallic taste
Some people with burning mouth syndrome don't wake up with mouth pain, but find that the pain intensifies during the day and into the evening. Some have constant daily pain, while others feel pain on and off throughout the day and may even have periods in which they feel no pain at all.
Burning mouth syndrome affects women seven times as often as men. It generally occurs in middle-aged or older adults. But it may occur in younger people as well.

Causes

The possible causes of burning mouth syndrome are many and complex. Each of the following possible causes applies to only a small portion of all people who complain of a burning mouth. Many people have multiple causes. Identifying all of the causes is important so that your doctor can develop a treatment plan tailored for you. Possible causes include:
  • Dry mouth (xerostomia). This condition can be related to use of certain medications, including tricyclic antidepressants, central nervous system depressants, lithium, diuretics and medications used to treat high blood pressure. It can also occur with aging or Sjogren's syndrome, an autoimmune disease that causes both dry mouth and dry eyes.
  • Other oral conditions. Oral yeast infection (thrush) is a common cause of a burning mouth that may also occur with other causes, such as diabetes, denture use and certain medications. Geographic tongue, a condition that causes a dry mouth and a sore, patchy tongue, also may be associated with burning mouth syndrome.
  • Psychological factors. Emotional disorders, such as anxiety and depression, are often associated with burning mouth syndrome, as is an extreme fear of cancer. Although these problems can cause a burning mouth, they may also result from it.
  • Nutritional deficiencies. Being deficient in nutrients, such as iron, zinc, folate (vitamin B-9), thiamin (vitamin B-1), riboflavin (vitamin B-2), pyridoxine (vitamin B-6) and cobalamin (vitamin B-12), may affect your oral tissues and cause a burning mouth. These deficiencies can also lead to vitamin deficiency anemia.
  • Irritating dentures. Dentures may place stress on some of the muscles and tissues of your mouth. The materials used in dentures also may irritate the tissues in your mouth.
  • Nerve disturbance or damage (neuropathy). Damage to nerves that control taste and pain in the tongue may also result in a burning mouth.
  • Allergies. The mouth burning may be due to allergies or reactions to foods, food flavorings, other food additives, fragrances, dyes or other substances.
  • Reflux of stomach acid (gastroesophageal reflux disease). The sour- or bitter-tasting fluid that enters your mouth from your upper gastrointestinal tract may cause irritation and pain.
  • Certain medications. Angiotensin-converting enzyme (ACE) inhibitors, used to treat high blood pressure, may cause side effects that include a burning mouth.
  • Oral habits. These include often-unconscious activities such as tongue thrusting and teeth grinding (bruxism), which can irritate your mouth.
  • Endocrine disorders. Your oral tissues may react to high blood sugar levels that occur with conditions such as diabetes and underactive thyroid (hypothyroidism).
  • Hormonal imbalances, such as those associated with menopause. Burning mouth syndrome occurs most commonly among postmenopausal women, although it affects many other people as well. Changes in hormone levels may affect the composition of your saliva.
  • Excessive irritation. Irritation of the oral tissues may result from excessive brushing of your tongue, overuse of mouthwashes or consuming too many acidic drinks.
Often, more than one cause is present. Despite careful evaluation, doctors are sometimes unable to find the cause of burning mouth symptoms.

When to seek medical advice

If you have persistent pain or soreness in your tongue, lips, gums or other areas of your mouth, see your doctor. Your doctor can search for the possible cause or causes to guide treatment.

Screening and diagnosis

Your doctor will review your medical history, examine your mouth and ask you to describe your symptoms, your oral habits and your oral care routine. In addition, he or she will likely perform a general medical examination, looking for signs of any associated conditions.
As part of the diagnostic process, you may undergo some of the following tests:
  • Complete blood cell count (CBC). This common blood test provides a count of each type of blood cell in a given volume of your blood. The CBC measures the amount of hemoglobin, the percentage of blood that's composed of red blood cells (hematocrit), the number and kinds of white blood cells, and the number of platelets. This blood test may reveal a wide variety of conditions, including infections and anemia, which can indicate nutritional deficiencies.
  • Other blood tests. Because nutritional deficiencies are one cause of a burning mouth, your doctor may collect blood samples to check blood levels of iron, zinc, folate (vitamin B-9), thiamin (vitamin B-1), riboflavin (vitamin B-2), pyridoxine (vitamin B-6) and cobalamin (vitamin B-12). Also, because diabetes may cause a burning mouth, your doctor may check your fasting blood sugar level.
  • Allergy tests. Your doctor may suggest allergy testing to see if you may be allergic to certain foods, additives or even substances in dentures.
  • Oral swab culture or biopsy. If your doctor suspects oral thrush, he or she may take a small tissue sample (biopsy) or an oral swab culture to be examined in the laboratory.
Because burning mouth syndrome is associated with such a wide variety of other medical conditions, your doctor may refer you to a specialist for screening and diagnosis and possibly treatment. Your health care team may include a dermatologist, dentist, psychiatrist, psychologist or a doctor who specializes in ear, nose and throat problems (otolaryngologist).

Treatment

Treatment triggers improvement in symptoms for most people with burning mouth syndrome. But the type of treatment depends on the underlying cause.
  • Dry mouth (xerostomia). Treating the cause of your dry mouth — Sjogren's syndrome, use of medications or some other cause — may relieve burning mouth symptoms. In addition, drinking more fluids or taking a medication that promotes flow of saliva may help.
  • Other oral conditions. If the cause is oral thrush, treatment is with oral antifungal medications such as nystatin (Mycostatin) or fluconazole (Diflucan). If you wear dentures, your dentures may also need to be treated.
  • Psychological factors. For a burning mouth that may be caused by or associated with psychological factors such as anxiety and depression, your doctor may recommend antidepressant therapy or psychiatric therapy or both together. Selective serotonin reuptake inhibitors (Prozac, Zoloft, others) may cause less dry mouth than other antidepressant medications.
  • Nutritional deficiencies. You may be able to correct nutritional deficiencies by taking supplements of B vitamins and minerals such as zinc and iron.
  • Irritating dentures. Your dentist may be able to adjust your dentures so they are less irritating to your mouth. If your dentures contain substances that irritate your oral tissues, you may need different dentures. You may also improve symptoms by practicing good denture care, such as removing dentures at night and cleaning them properly.
  • Nerve disturbance or damage (neuropathy). Your doctor may suggest medications that affect your nervous system and control pain, including benzodiazepines such as clonazepam (Klonopin), tricyclic antidepressants such as amitriptyline or nortriptyline (Pamelor, Aventyl), or anticonvulsants such as gabapentin (Neurontin). For pain relief, your doctor may also suggest rinsing your mouth with water and capsaicin — the active ingredient in hot peppers, which also is called capsicum.
  • Allergies. Avoiding foods that contain allergens that may irritate the tissues of your mouth may help.
  • Certain medications. If a medication you're taking is causing a burning mouth, using a substitute medication, if possible, may help.
  • Oral habits. Tongue thrusting and teeth grinding (bruxism) can be helped with mouth guards, medications and relaxation techniques.
  • Endocrine disorders. If a burning mouth is associated with conditions such as diabetes or hypothyroidism, treating those conditions may improve your symptoms.
If doctors can't identify the cause of your symptoms, they may still recommend trying oral thrush medications, B vitamins or antidepressants. These medications have proved effective in treating burning mouth syndrome.

Coping skills

Burning mouth syndrome can be painful and frustrating. The good news is that it's a treatable condition. Although it may take time, with the help of a team of health professionals, you can usually find a treatment plan that's right for you.

In the short term, you may gain some relief by avoiding irritating substances, such as alcohol-based mouthwashes, cinnamon or mint products, and cigarette smoke. Chewing on ice chips or sugar-free gum also may help. So can keeping your dentures out all night and brushing your teeth with baking soda instead of toothpaste. Ask your doctor for other tips to manage your pain and discomfort.

Article Source: http://www.colgateprofessional.com/patienteducation/Burning-Mouth-Syndrome/article

David L. Kitchen, DDS
9850 Genesee Avenue
Suite 540
La Jolla, CA 92037
Telephone: 858.558.1946
info@davidkitchendds.com

Follow us on Twitter @lajollateeth
http://www.cosmeticdentistryforsandiego.com

Thursday, June 21, 2012

New Video From David Kitchen's Office

New video from our office! Learn about how to properly care for your teeth. 








David L. Kitchen, DDS
9850 Genesee Avenue
Suite 540
La Jolla, CA 92037
Telephone: 858.558.1946
info@davidkitchendds.com


Follow us on Twitter @lajollateeth
http://www.cosmeticdentistryforsandiego.com

Tuesday, June 12, 2012

What is Good Oral Hygiene?



What is Good Oral Hygiene?

Good oral hygiene results in a mouth that looks and smells healthy. This means:
  • Your teeth are clean and free of debris
  • Gums are pink and do not hurt or bleed when you brush or floss
  • Bad breath is not a constant problem
If your gums do hurt or bleed while brushing or flossing, or you are experiencing persistent bad breath, see your dentist. Any of these conditions may indicate a problem.
Your dentist or hygienist can help you learn good oral hygiene techniques and can help point out areas of your mouth that may require extra attention during brushing and flossing.
How is Good Oral Hygiene Practiced?
Maintaining good oral hygiene is one of the most important things you can do for your teeth and gums. Healthy teeth not only enable you to look and feel good, they make it possible to eat and speak properly. Good oral health is important to your overall well-being.
Daily preventive care, including proper brushing and flossing, will help stop problems before they develop and is much less painful, expensive, and worrisome than treating conditions that have been allowed to progress.
In between regular visits to the dentist, there are simple steps that each of us can take to greatly decrease the risk of developing tooth decaygum disease and other dental problems. These include:
  • Brushing thoroughly twice a day and flossing daily
  • Eating a balanced diet and limiting snacks between meals
  • Using dental products that contain fluoride, including toothpaste
  • Rinsing with a fluoride mouthrinse if your dentist tells you to
  • Making sure that your children under 12 drink fluoridated water or take a fluoride supplement if they live in a non-fluoridated area.
Proper Brushing Technique
brush1brush2brush3
Tilt the brush at a 45° angle against the gumline and sweep or roll the brush away from the gumline.
Gently brush the outside, inside and chewing surface of eachtooth using short back-and-forth strokes.
Gently brush your tongue to remove bacteria and freshen breath.
Proper Flossing Technique
floss1floss2floss3
Use about 18" of floss, leaving an inch or two to work with.
Gently follow the curves of your teeth.
Be sure to clean beneath the gumline, but avoid snapping the floss on the gums.
Article Source: http://www.colgate.com/app/CP/US/EN/OC/Information/Popular-Topics/Oral-Health-Basics/article/What-is-Good-Oral-Hygiene.cvsp

David L. Kitchen, DDS
9850 Genesee Avenue
Suite 540
La Jolla, CA 92037
Telephone: 858.558.1946
info@davidkitchendds.com
http://www.cosmeticdentistryforsandiego.com

Tuesday, June 5, 2012

Illustrations: How A Tooth Decays



  1. Healthy Tooth

    Healthy Tooth
    Enamel is the hard outer crystal-like layer. Dentin is the softer layer beneath the enamel. The pulp chamber contains nerves and blood vessels and is considered the living part of the tooth.
  2. White Spots
    White Spots
    Bacteria that are exposed to sugars or carbohydrates can make acid, which attacks the crystal-like substance in the tooth's outer surface. This process is known as demineralization. The first sign of this is a chalky white spot. At this stage, the decay process can be reversed. Using fluorides at home and in the dental office can help the tooth repair itself.
  3. Enamel Decay
    Enamel Decay
    Demineralization continues. Enamel starts to break down. Once the enamel surface is broken, the tooth can no longer repair itself. The cavity has to be cleaned and restored by a dentist.
  4. Dentin Decay
    Dentin Decay
    The decay reaches into the dentin where it can spread and undermine the enamel.
  5. Pulp Involvement
    Pulp Involvement
    If decay is left untreated, it will reach the tooth's pulp, which contains nerves and blood vessels. The pulp becomes infected. An abscess (swelling) or a fistula (opening to the surface of the gum) can form in the soft tissues.
*Illustrations created by Simple Steps designer Lynda Buchhalter

Feel free to contact our La Jolla Dental office for additional information or to set-up an appointment.


David L. Kitchen, DDS
9850 Genesee Avenue
Suite 540
La Jolla, CA 92037
Telephone: 858.558.1946
info@davidkitchendds.com
http://www.cosmeticdentistryforsandiego.com


Connect with us on Twitter: twitter.com/lajollateeth

Committed to Creating Healthy, Beautiful Smiles for over 25 Years

Friday, June 1, 2012

New Video Featuring Dr. Kitchen!




Dr. David L. Kitchen has been practicing in La Jolla/San Diego for over 25 years. Dr. Kitchen emphasizes exceptional customer service, individualized attention and sees new patients as well as old patients, for all dental services including dental emergencies.


http://www.cosmeticdentistryforsandiego.com


Our patients become family and are treated with personalized attention. We use only the best labs and highest quality dental products for all treatments, including restorations. These modern and most up-to-date technologies aide Dr. Kitchen in producing extraordinary smiles making our patients visits, care and experience superior.


Feel free to contact our La Jolla Dental office for additional information or to set-up an appointment.


David L. Kitchen, DDS
9850 Genesee Avenue
Suite 540
La Jolla, CA 92037


Telephone: 858.558.1946
info@davidkitchendds.com


http://www.cosmeticdentistryforsandiego.com


Connect with us on Twitter: twitter.com/lajollateeth


Committed to Creating Healthy, Beautiful Smiles for over 25 Years