Patients with burning mouth syndrome have a tingling, burning, or numb sensation on the lips, tongue, and/or inside of the mouth. No visual signs, such as redness or swelling, accompany these sensations. You may experience symptoms that come and go or that increase steadily throughout the day. Others may have some symptom-free days. Possible causes of burning mouth syndrome include nutritional deficiencies, anxiety or depression, or nerve problems (such as damage to certain craniofacial nerves), although none of these causes has been proven.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drug Breakthrough Option: Clonazepam
The soft tissues within the mouth and the rest of the digestive tract contain some of the most rapidly dividing cells in the body. Treatments for cancer, such as chemotherapy and radiation, aim to stop or slow the rate at which abnormal cancer cells divide and reproduce. Because normal cells in the digestive tract also divide and reproduce rapidly, cancer treatments can slow the normal growth and repair of these tissues often leading to stomatitis (tissues lining the oral cavity are inflamed and painful) and/or mucositis (a painful inflammation of the cells that line the entire digestive tract, occurring from mouth to anus). These conditions are a common side effect of cancer treatments, especially with the anti-cancer drug 5-Fluorouracil.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Allopurinol, Amifostine, Dicyclomine, Sucralfate, Lidocaine
Canker sores, or aphthous stomatitis, are shallow ulcers that form in the soft tissues of the mouth — usually on the insides of the cheeks, on the tongue, or on the base of the gums. The cause of canker sores is unknown in most cases, but they are sometimes related to stress, other illnesses, or certain medications. They are painful and can make it uncomfortable to talk or eat. They are not contagious and are not related to the cold sores caused by herpes simplex virus. Canker sores usually go away without treatment within 7–10 days, although treatment may be needed in more severe cases.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Colchicine, Prednisone, Betamethasone, Clobetasol, Dexamethasone, Fluocinonide
Gingival enlargement, also known as gingival hyperplasia or enlargement of the gums, can be caused by certain drugs — most commonly, phenytoin, cyclosporin, or nifedipine, which are often used to prevent organ rejection in transplant recipients. These drugs may interfere in the normal breakdown of types of cells in gum tissue. Because these cells are not sloughed off normally, the gums become enlarged, appear puffy and red, are tender to the touch, and may bleed easily. In very severe cases, your teeth may be partially or even completely obscured.
Commonly Prescribed (On-Label) Drugs: None
Off-Label Prescription Drugs Breakthrough Options: Azithromycin, Chlorhexidine Gluconate
Gingivitis is an inflammation of the gums (gingiva) that produces soreness, redness, and swelling. It is most commonly caused by a buildup of tartar and plaque, a sticky substance produced by bacteria that forms on teeth surfaces. When teeth are not cleaned regularly, plaque hardens into tartar, which builds up on the base of the teeth and can irritate the gums. If this tartar buildup is not removed, the gums may become increasingly inflamed and infected with the many strains of bacteria that the mouth normally harbors. Gingivitis can also be caused by injury or trauma to the gums, such as that caused by brushing or flossing too forcefully, or by poorly fitting dentures or crowns. Allergic reactions may also cause gingivitis.
Commonly Prescribed (On-Label) Drugs: Chlorhexidine
Off-Label Prescription Drugs Breakthrough Options: Ciprofloxacin, Clindamycin, Doxycycline, Erythromycin, Metronidazole
Oral leukoplakia is a clinical term for a white lesion on the tongue or on the inside of the mouth whose cause is unknown. Only when a biopsy or sample of the lesion is taken can a doctor determine if the lesion is dysplastic or pre-cancerous. If it is dysplastic, the cells of the lesion have early signs of cancer and may eventually develop into cancer, though this is rare.
An oral leukoplakia that is dysplastic may appear as a white or gray, thick, and slightly raised patch, forming over weeks or months. The lesions are usually painless, but may become sensitive to heat, spicy foods, or other irritation. Often, oral leukoplakias are attributed to rough teeth or dentures that irritate the tissues of the tongue or mouth. Smoking also appears to increase the risk of dysplastic oral leukoplakia.
Commonly Prescribed (On-Label) Drugs: Aminolevulinic Acid, Deflazacort, Dexamethasone, Hydrocortisone, Methylprednisolone
Off-Label Prescription Drugs Breakthrough Options: Bleomycin, Isotretinoin, Tretinoin
Lichen planus is a skin disease that causes reddish or purplish bumps on the skin. Lichen planus can also affect the oral cavity, causing white or mixed red and white lesions inside the mouth, on the gums, or under the tongue. In the most common form of oral lichen planus, However, in severe cases, they can be painful and persistent, and may interfere with eating, swallowing, speaking, or toothbrushing. The cause of oral lichen planus is not known but researchers believe it is related to an immune or allergic-type reaction.
Commonly Prescribed (On-Label) Drugs: Dexamethasone
Off-Label Prescription Drugs Breakthrough Options: Betamethasone, Dexamethasone, Clobetasol, Azathioprine, Mycophenolate Mofetil, Tacrolimus, Isotretinoin
Periodontitis is a deep infection in the gums around the base of the tooth. Unlike gingivitis, which is marked by relatively minor redness and swelling of the gums, periodontitis is a more severe bacterial infection. In periodontitis, the gums begin to pull away from the teeth, forming pockets that harbor the growth of bacteria. Left untreated, the infection in these pockets can spread into the tissue beneath the gum line and into the underlying bone and connective tissue. Alveolar bone, a thin layer of compact bone that forms the tooth socket surrounding the roots of teeth, may be lost and the teeth may need to be removed as a result.
Commonly Prescribed (On-Label) Drugs: Chlorhexidine, Doxycycline, Tetracycline
Off-Label Prescription Drugs Breakthrough Options: Ciprofloxacin, Clindamycin, Erythromycin, Metronidazole, Flurbiprofen, Ibuprofen, Ketoprofen, Meloxicam, Naproxen
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