Expert: Joel S. Teig, DMD, Diplomate ABOMS, retired - 4/23/2005

Question
Thank you very much for responding to my question.  Can you please tell me what causes inflammation in ones mouth?  As you are aware, I do have anxiety over this issue since I do have a huge fear of cancer.  I sometimes just don't get what I might be doing wrong since this seems to come in episodes.  I eat at least one yogurt a day, take acidoplidus (misspelled) twice a day, brush twice a day along with flossing, use Listerine morning and night.  I do realize that anxiety along with medications like Bendryl can cause dry mouth.  Please help explain.  Thank you again for your time.


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Followup To
Question -
Hi, I'm sure that you probably remember me, 27 yr. old female, huge fear of cancer.  Only medication taking is multi-vitamin w/ numerous supplements, birth control pill, Xanax when needed.  I did just start taking Allegra-D today due to really high pollen lately.  I keep getting these periodic episodes of burning mouth.  Mainly on my tongue and roof of my mouth along with dryness and I will sometimes have metallic taste.  I will wake up feeling fine in the mornings but as the morning progresses the stinging/burning/tingling feeling gets worse and worse but its relieved when I drink water and eat food and suck on some sugar free candy. If I suck on too much candy, it upsets my stomach. But I have also noticed that when I suck on the first piece of candy, it seems like it triggers or intensifies the tingling/burning or if I drink coffee. I have found that taking Xanax relieves a lot of the burning at times.  I have been to my dentist umpting times along with ENT doctor, periodontist (TMJ) and they all don't see anything.  I actually seen my dentist the first of March for 6 month checkup/cleaning, everything fine.  I sometimes feel like its all in my head but majority of the time I don't feel anxious and/or paniced.  I have taken your advice about not looking in my mouth anymore.  I just don't know what to do at this point since it seems to come in episodes. Like just when I feel like its behind me, it starts up again. Can you offer any insight into this matter or what the next step should be?  Could this all be anxiety related?  I don't want to get back into the habit of overreacting and rushing off to every doctor.  Thank you for your time.
Answer -
Tara- you may have burning from a mild inflammation, but I am sure that anxiety over the burning exacerbates it.  
The fact that sugar free candies help shows that the inflammation is very mild.  

Many people get stomach upsets with sugar free candies.  I am including  website of various artificial saliva substitutes which will definitely help. Try them:
http://www.dentalgentlecare.com/dry_mouth_products.htm

Good luck

Answer
Tara -  The cause for inflammations in the mouth is a multifaceted sword.  Any noxious element either ingested, inhaled or produced within the body (such as bacteria) can produce inflammation. The great difficulty is diagnosing any inflammation is to first eliminate the various causes one by one and hopefully the noxious element can be found.

A learned professor of mine once said, "if you were to take ketchup on a daily basis and place it on a small abrasion in which the skin had been violated, eventually a major inflammatory reponse will occur".  

In the mouth, we are constantly insulting the oral tissues with many noxious agents.  The protecting factor that limits the inflammatory response is the production of a mucous like layer of saliva.  This can usually protect and eliminate the noxious substance.  When, however, the noxious element flood the area or the protective layer is reduced inflammation occurs.

Your apparant constant battle with salivary production may be the factor that allows for inflammation to develop.  The most noted doctor in the US on saliva and salivary production is at Columbia University Dental School.  His name is Irwin Mandel, DDS.  You have so many issues with your lack of salivary production, I think that making an effort to make and appointment with Dr. Mandel may address your issues and help allay your fears.

Good Luck.