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Burning Mouth Syndrome




Real or Imaginary Syndrome?
BURNING MOUTH SYNDROME
•   Chronic Pain
•   Sleep Problems
•   Food Not Enjoyable
•   Depression
•   Frustration
•   Feel Crazy
•   Anxiety
WHAT USUALLY HAPPENS
• YOU SEE MULTIPLE DOCTORS
  – ENT
  – FAMILY PRACTICE
  – DENTIST
  – NEUROLOGIST
  – ALLERGIST
  – ORAL SURGEON
  – ALTERNATIVE PRACTITIONERS
WHAT USUALLY HAPPENS

•   MRI OF HEAD
•   BIOPSY OF TONGUE
•   CULTURES FOR YEAST
•   ALLERGY TESTING
•   BLOOD TESTS
WHAT USUALLY HAPPENS
• ALMOST 3 YEARS FROM START OF SYMPTOMS
  TO DIAGNOSIS OF BMS

• SYMPTOMS PERSIST FOR MONTHS OR YEARS

• 20 % GOES AWAY AFTER 6-7 YEARS

• USUALLY NEEDS TREATMENT
TREATMENTS RARELY SUCCESSFUL
•   Psychological Treatment-CBT
•   Anti-depressants
•   Topical Klonipin
•   Mouthwashes
•   Mouth pastes
•   Supplements
THE USUAL POINT OF VIEW
 Traditional Medical Point of View
“A burning sensation for which no
dental or medical cause can be found”




• International Headache Society, 2004
THE USUAL POINT OF VIEW
• EVERYTHING LOOKS FINE
• I DON’T SEE ANY CAUSE FOR PAIN
• TREATMENTS DON’T WORK
           THEREFORE…..
    BMS MUST BE IMAGINARY !
You’ll Have to Live With It
DREAD
 “Most clinicians dread seeing the patient
  presenting with a primary complaint of a
  burning pain…”




International Journal of Oral Science, 2 (1): 1-4, 2010
A Challenge, to Say the Least
  “The patient with a complaint of a burning
   sensation of the oral mucosa presents one of
   the most difficult challenges to the care
   professional.”




International Journal of Oral Science, 2 (1): 1-4, 2010
We’ve Got a Problem, Houston
WHAT ARE THE NAMES FOR THIS?

•   Burning Tongue Syndrome
•   Burning Mouth Syndrome
•   Glossodynia= tongue pain
•   Stomatodynia= mouth pain
WHAT ARE THE SYMPTOMS?
•   Feeling of being scalded
•   Feeling of being burnt
•   Usually every day, but may vary
•   Worsens through the day
•   Intensity moderate to severe
•   Similar to a toothache
•   May improve with eating, drinking
•   May interfere with sleep
WHAT ELSE?

• Bitter or metallic taste
• Dry mouth
• Too much saliva
WHERE ARE THE SYMPTOMS?
•   Often more than one site
•   Tip of the tongue
•   Roof of the mouth
•   Lining of the lower lip
•   Less Common Sites of Burning:
    –   Throat
    –   Nasal passages
    –   Eyes
    –   Chest
    –   Skin surfaces
CLUES
WHO GETS BMS?
• 90% ARE PERIMENOPAUSAL AND
  MENOPAUSAL WOMEN
• 80% of WOMEN WHO HAVE OVARIES
  REMOVED GET BMS
• USUALLY OLDER AGE PEOPLE
WHAT HAPPENS AT PERIMENOPAUSE?
Hormone Rollercoaster
WHAT HAPPENS AT MENOPAUSE?
          Hormones Disappear
  5
4.5
  4
3.5
  3
2.5
  2
1.5
  1
0.5
  0
       20 years old   30 years old    40 years old   50 years old
                       Progesterone   Estrogen
WHAT HAPPENS WITH AGING?
45
        HORMONES DECLINE
40


35


30


25


20
                                Testosterone
                                DHEA
15


10


5


0




     20   30   40   50   60 years
MORE CLUES




ARE YOU STRESSED?
Hormones Decline With Stress
WHAT ELSE HAPPENS IN BMS?
• ELECTRICAL MALFUNCTION IN NERVES
THE LATEST SCIENTIFIC EVIDENCE:
     BMS IS A NERVE PROBLEM

• FEWER NERVES SEEN ON TONGUE BIOPSY IN
  BMS
• ABNORMAL NERVE FUNCTION IN BMS
• ABNORMAL PAIN MEASUREMENTS IN BMS
PERFECT STORM
• Hormone Decline
  – MENOPAUSE
  – AGING
  – STRESS
• Nerve Damage
  – TONGUE
  – BRAIN
The Perfect Storm
                               NERVE
  DECREASED
HORMONE LEVELS       +        DAMAGE




                    BMS
                 DEPRESSION
                  ANXIETY
Testimonial From a Dr. Sklar Patient

• “I've noticed increased muscle definition after
  two months on my hormone program. I'm
  sleeping better. My burning tongue is not
  nearly as bad. My mood swings are not as
  intense. I feel great!”
                        J.B., Fitness Professional
Dr. Susan Sklar


Expert in the medical field of hormone
  restoration and neurotransmitter balancing
Fellow of the American Academy of Anti-Aging
  and Regenerative Medicine
Who Comes To See Me
•   Men
•   Women
•   Weight
•   Menopause
•   Depression
•   Anxiety
•   Insomnia
•   Low sex drive
What I Do
Help patients feel better with hormones
Help patients look and feel younger
Help patients be happier and more successful
Anti-Aging and Regenerative Medicine
•   We treat with hormones
•   We treat with nutritional supplements
•   Looks at aging as a process to be managed.
•   An integrative, healthcare approach
•   Reversal of age-related decline
Anti-Aging & Restorative Medicine
Problem Solvers
Unconventional
Scientific
Cutting Edge




                   Medical Pioneers
Burning Mouth Syndrome
HORMONES NOURISH NERVES
HORMONES HEAL NERVES
• NERVE PAIN
• DEPRESSION
• ANXIETY
HELP IS ON THE WAY
BMS ADVANCED SUPPORT
BMS ADVANCED SUPPORT
“The burning and metallic taste diminished
quite a bit. I could taste food again. That was
a big improvement. After 1 ½ months, the
nasal itching, burning in my eyes and
hoarseness went away.”
Ernie
BMS ADVANCED SUPPORT
Dear Dr. Susan Sklar,

  A sincere thank you for your support and providing me
  with relief from my "burning tongue " syndrome . After 3
  weeks my symptoms completely disappeared ! It was a very
  scary and painful situation . I am extremely grateful to
  have found you and appreciate your follow ups throughout
  my ordeal.

Sincerely,
Linda M.
BMS ADVANCED SUPPORT
  “Burning tongue has dropped to virtually
     nothing most days. Amazing!”

Linda T., BMS for 11 years
IS IT IMAGINARY?
IS THERE RELIEF FOR BMS?
Take Our Burning Tongue Assessment
                 Tool
• Click on “Take Me To My Survey” button
THANK YOU!

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Burning Mouth Syndrome: Hormone Imbalance and Nerve Damage

  • 1. Burning Mouth Syndrome Real or Imaginary Syndrome?
  • 2. BURNING MOUTH SYNDROME • Chronic Pain • Sleep Problems • Food Not Enjoyable • Depression • Frustration • Feel Crazy • Anxiety
  • 3. WHAT USUALLY HAPPENS • YOU SEE MULTIPLE DOCTORS – ENT – FAMILY PRACTICE – DENTIST – NEUROLOGIST – ALLERGIST – ORAL SURGEON – ALTERNATIVE PRACTITIONERS
  • 4. WHAT USUALLY HAPPENS • MRI OF HEAD • BIOPSY OF TONGUE • CULTURES FOR YEAST • ALLERGY TESTING • BLOOD TESTS
  • 5. WHAT USUALLY HAPPENS • ALMOST 3 YEARS FROM START OF SYMPTOMS TO DIAGNOSIS OF BMS • SYMPTOMS PERSIST FOR MONTHS OR YEARS • 20 % GOES AWAY AFTER 6-7 YEARS • USUALLY NEEDS TREATMENT
  • 6. TREATMENTS RARELY SUCCESSFUL • Psychological Treatment-CBT • Anti-depressants • Topical Klonipin • Mouthwashes • Mouth pastes • Supplements
  • 7. THE USUAL POINT OF VIEW  Traditional Medical Point of View
  • 8. “A burning sensation for which no dental or medical cause can be found” • International Headache Society, 2004
  • 9. THE USUAL POINT OF VIEW • EVERYTHING LOOKS FINE • I DON’T SEE ANY CAUSE FOR PAIN • TREATMENTS DON’T WORK THEREFORE….. BMS MUST BE IMAGINARY !
  • 10. You’ll Have to Live With It
  • 11. DREAD “Most clinicians dread seeing the patient presenting with a primary complaint of a burning pain…” International Journal of Oral Science, 2 (1): 1-4, 2010
  • 12. A Challenge, to Say the Least “The patient with a complaint of a burning sensation of the oral mucosa presents one of the most difficult challenges to the care professional.” International Journal of Oral Science, 2 (1): 1-4, 2010
  • 13. We’ve Got a Problem, Houston
  • 14. WHAT ARE THE NAMES FOR THIS? • Burning Tongue Syndrome • Burning Mouth Syndrome • Glossodynia= tongue pain • Stomatodynia= mouth pain
  • 15. WHAT ARE THE SYMPTOMS? • Feeling of being scalded • Feeling of being burnt • Usually every day, but may vary • Worsens through the day • Intensity moderate to severe • Similar to a toothache • May improve with eating, drinking • May interfere with sleep
  • 16. WHAT ELSE? • Bitter or metallic taste • Dry mouth • Too much saliva
  • 17. WHERE ARE THE SYMPTOMS? • Often more than one site • Tip of the tongue • Roof of the mouth • Lining of the lower lip • Less Common Sites of Burning: – Throat – Nasal passages – Eyes – Chest – Skin surfaces
  • 18. CLUES
  • 19. WHO GETS BMS? • 90% ARE PERIMENOPAUSAL AND MENOPAUSAL WOMEN • 80% of WOMEN WHO HAVE OVARIES REMOVED GET BMS • USUALLY OLDER AGE PEOPLE
  • 20. WHAT HAPPENS AT PERIMENOPAUSE? Hormone Rollercoaster
  • 21. WHAT HAPPENS AT MENOPAUSE? Hormones Disappear 5 4.5 4 3.5 3 2.5 2 1.5 1 0.5 0 20 years old 30 years old 40 years old 50 years old Progesterone Estrogen
  • 22. WHAT HAPPENS WITH AGING? 45 HORMONES DECLINE 40 35 30 25 20 Testosterone DHEA 15 10 5 0 20 30 40 50 60 years
  • 23. MORE CLUES ARE YOU STRESSED?
  • 25. WHAT ELSE HAPPENS IN BMS? • ELECTRICAL MALFUNCTION IN NERVES
  • 26. THE LATEST SCIENTIFIC EVIDENCE: BMS IS A NERVE PROBLEM • FEWER NERVES SEEN ON TONGUE BIOPSY IN BMS • ABNORMAL NERVE FUNCTION IN BMS • ABNORMAL PAIN MEASUREMENTS IN BMS
  • 27. PERFECT STORM • Hormone Decline – MENOPAUSE – AGING – STRESS • Nerve Damage – TONGUE – BRAIN
  • 28. The Perfect Storm NERVE DECREASED HORMONE LEVELS + DAMAGE BMS DEPRESSION ANXIETY
  • 29. Testimonial From a Dr. Sklar Patient • “I've noticed increased muscle definition after two months on my hormone program. I'm sleeping better. My burning tongue is not nearly as bad. My mood swings are not as intense. I feel great!” J.B., Fitness Professional
  • 30. Dr. Susan Sklar Expert in the medical field of hormone restoration and neurotransmitter balancing Fellow of the American Academy of Anti-Aging and Regenerative Medicine
  • 31. Who Comes To See Me • Men • Women • Weight • Menopause • Depression • Anxiety • Insomnia • Low sex drive
  • 32. What I Do Help patients feel better with hormones Help patients look and feel younger Help patients be happier and more successful
  • 33. Anti-Aging and Regenerative Medicine • We treat with hormones • We treat with nutritional supplements • Looks at aging as a process to be managed. • An integrative, healthcare approach • Reversal of age-related decline
  • 34. Anti-Aging & Restorative Medicine Problem Solvers Unconventional Scientific Cutting Edge Medical Pioneers
  • 37. HORMONES HEAL NERVES • NERVE PAIN • DEPRESSION • ANXIETY
  • 38. HELP IS ON THE WAY
  • 40. BMS ADVANCED SUPPORT “The burning and metallic taste diminished quite a bit. I could taste food again. That was a big improvement. After 1 ½ months, the nasal itching, burning in my eyes and hoarseness went away.” Ernie
  • 41. BMS ADVANCED SUPPORT Dear Dr. Susan Sklar, A sincere thank you for your support and providing me with relief from my "burning tongue " syndrome . After 3 weeks my symptoms completely disappeared ! It was a very scary and painful situation . I am extremely grateful to have found you and appreciate your follow ups throughout my ordeal. Sincerely, Linda M.
  • 42. BMS ADVANCED SUPPORT “Burning tongue has dropped to virtually nothing most days. Amazing!” Linda T., BMS for 11 years
  • 44. IS THERE RELIEF FOR BMS?
  • 45. Take Our Burning Tongue Assessment Tool • Click on “Take Me To My Survey” button