Hi, I don't usually post on forums but joined this time to post on this topic.
Unfortunately, I also have burning mouth syndrome and over the 6 months I have had it, have pretty much become the poster child for what not to do when you have burning mouth syndrome.
Mine started in early August 2018, and was an instant reaction to a mouth inhaled asthma medication called Breo Ellipta. The morning after my first dose I woke up and my pallette felt rough and bumpy. My GP suggested I treat for thrush and keep using it. I started Daktarin gel and after a few more doses of the medication realised my mouth felt really dry and would get worse as the day progresses. After about 5 doses I stopped the asthma medication and over three weeks my mouth gradually went back to normal. I knew something weird had happened but didn't know what.
Unfortunately I was doing an extremely stressful job with an impossible workload and when I got short of breath again I took another dose of the Breo. (I had not intended to use it again but wasn't thinking clearly) The next day I woke up with the same dry mouth and I've had burning mouth ever since.
For the first two weeks after it retriggered I predominantly had the dry mouth, but then I started getting the pain and I realised it was BMS. I'm a doctor so had heard of it and then freaked out at the poor propgnosis and lack of treatment. I was also struggling to work because I have to talk all day to patients which is very hard with a dry, painful mouth.
I saw an oral pathologist who was very reassuring and said that it almost always goes away on it's own (he said in 95% of patients he sees), in one month to one year. I was very happy to hear this but then went back to my very stressful job, which was made even worse by my pain and dry mouth and I wasn't coping and getting more stressed.
By mid October I couldn't take anymore and took a month sick leave to trial clonazepam 0.25 mg twice day. Unfortunately, the pathologist had not made clear that this only treats pain and not the dry mouth, and at this point dry mouth was still my main problem, with pain on some days. After two doses of clonazepam my dry mouth was astronomically worse and my pain went from intermittent to a raging agony that affected my whole mouth and lasted 24/7.
At this point my brain broke and I became severely depressed and agitated, which made the BMS even worse. I ended up needing hospital treatment for 3 weeks and it took until Christmas to recover from the depression and feel myself again.
I had also lost 16 kg from not being able to eat.
Since then my symptoms have improved a bit. I had three weeks where it seemed to be winding down - I would have one good day, then one bad day but the good days got better and the bad days not as bad. Then in one week I had three days when the pain was almost gone, although my mouth was even dryer. Unfortunately, a week and a half ago it turned around and went bad again, so I'm feeling like I almot got to the top of the mountain, then slid back down again.
So my suggestions to anyone who has this:
- above all else guard your mental state. It is very hard not to be depressed and anxious with this, as it brings so much uncertainty to your life and leaves you constantly second guessing what you may have done or eaten to make it worse. If your mood slips, go on an anti-depressant sooner rather than later. It's easier to cope with the pain when you're not depresssed and while BMS is definitely not a psychogenic illness, I do think depression and anxiety can make it worse and slow recovery. I don't think mine would ever have become as bad as it is if I hadn't freaked out and got depressed
- force yourself to eat as rapid weight loss is also not going to help your immune system
tiffaney - I can only sympathise, as it seems we are BMS twins and our onset and symptoms have been during the same time period.
I have not tried any treatment, except for the clonazepam, although I think this made me worse. However, some people do report success with it.
Other things you could try (and this is based on case reports)
if your mouth is not dry
- duloxetine 60 mg day
- amitriptyline 10-25 mg at night. Most people don't tolerate more than 25 mg because it is so sedating but some people do go up to 50 mg.
Both of these medications are useful with nerve pain
Lyrica - my GP had a patient whose pain greatly improved on a low dose of 75 mg at night. I'm considering trying this now but am wary as I have had so many weird adverse drug reactions and seem very sensitive to medication.
Leavingnormal - during all of this I also developed intermittent burning pain in my feet, legs, hand and face. I saw a neurologist who has diagnosed me with small fibre neuropathy. Your description of sensitive burning skin sounds a lot like this, so you may want to get checked out by a neurologist. Apparently it sometimes responds to gabapentin.
So I am trying to remain hopeful, that this will go away on it's own at some point, as the oral pathologist said.
It's very hard because I can no longer work, and this was really important to me. I love being a doctor and have spent so long training it is devestating to not be able to use my skills. Hopefully I can talk again soon.
Best wishes to everyone. This really is a horrible condition - you couldn't design a worse torture.