June 2022

Oral Burning without Local Inflammation

Oral burning is a complex series of symptoms associated with a usual persistent burning sensation in the oral cavity. It usually comes on spontaneously without a specific etiology, but it occurs more frequently in older women. It usually involves the tongue hence the name glossopyrosis. But it can also include several structures in the mouth including gums, palette, cheeks, and lips, thereby the term oropyrosis. There are usually no oral lesions associated with the burning, although it is commonly associated with an abnormal taste in the absence of food hence the name phantageusia. This sensation is also unpleasant and is commonly described as bitter, metallic or burned associated with the oral burning.

We have tried to separate the various aspects of oral burning- pyrosis- into its component parts in order to attempt to understand the nature of the pyrosis. However, it can be difficult to separate glossopyrosis from the burning which affects the entire mouth. This lack of information has caused much confusion.

Treatment for this disorder has been difficult. However, we have used transcranial magnetic stimulation of the brain to alleviate the symptom complex with modest success, depending upon increase of brain GABA levels to alleviate the oral burning.