#115 Burning Mouth & Tongue and TMD/TMJ

Burning tongue or other less than comfortable sensations of the tongue is a relatively rare phenomenon. According to the Journal of the American Medical Association, Section on Otolaryngology, burning mouth syndrome occurs in about 90 to 120 of 100 000 people, although some studies report a frequency as high as 18% of the population. Women are 7 times more likely to have burning mouth syndrome. Age is a known risk factor, with an average age at diagnosis of 59 years. According to the AMA Journal there is no known cause for Burning Mouth/Tongue and no known effective treatment.  Some benefits concerning quality of life have been shown using cognitive behavioral therapy (Talk Therapy).   

Don’t know about you, but I think it is very odd that, #1, Burning Mouth and Tongue is 7 times more frequent in women than men, and #2, talk therapy would have any chance to have a positive effect on this often frustrating and debilitating problem.  

Although the AMA admits Burning Mouth and Tongue is an enigma, from my viewpoint I believe there is always a solution to a problem, medical or otherwise.  If there is no solution in sight, you are either asking the wrong question or asking the wrong person or source for a solution. 

In the case of Burning Mouth and Tongue maybe the physicians are asking the wrong source.  Maybe they should be looking to the dental profession, especially that part of the dental profession that deals with the symptoms and treatment of TMD/TMJ. 

Having now successfully treated over 4,000 patients with symptoms of TMD/TMJ, I have had several TMD patients tell me that as the well-known  TMD/TMJ symptoms begin to dissipate, their symptom of burning tongue also decreases.  The first time this occurred, I blew it off as just co-incidence, but eventually, I encountered  more patients with the same history and response and took a deep dive into figuring out how TMD/TMJ, which is nothing more than unresolved chronic inflammation within the temporomandibular joint, (TMJ), could also cause the sensation of burning tongue. 

Having an advanced degree in Anatomy and Cell Biology I pulled out my copy of “Gray’s Anatomy” and began to study the anatomical relationship between the temporomandibular joint and that of the tongue. What I found suggested a very simple explanation for the symptom 

It has been shown in prior studies that chronic inflammation from the temporomandibular joint can travel into the middle ear causing the well accepted TMD/TMJ symptoms of ringing in the ears, vertigo and subjective hearing loss. Inflammatory exudates travel through a small and short fissure, (Petrotympanic Fissure) from the jaw joint into the middle ear.  But apparently, no one has connected the fact that also transversing the Petrotympanic Fissure is a small nerve called the Chorda Tympany which singularly innervates the anterior two-thirds of the tongue primarily supplying the nerves that elicit taste.  As these inflammatory infiltrates traverse the fissure it would also damage the Chorda Tympany causing an errant burning sensation to the anterior two thirds of the tongue.  Studies have confirmed that patients have confusion and difficulty distinguishing errant sensations of the tongue with other parts of the mouth.  This would explain how patients generalize the description of burning tongue and mouth. 

Just as in burning tongue, TMD/TMJ is much more prominent in women than men.  This is because the female hormone, estrogen, exacerbates and stimulates chronic inflammation.  This fact has been known and published in the scientific literature for over 60 years. Thus, TMD/TMJ and burning tongue have nothing to do with the commonly perceived and derogatorily noted comment that women have a tendency to talk more than men.   

There is a relationship between TMD/TMJ and Burning Tongue.  Some of my patients have confirmed this.  But multiple anecdotal experiences do not make science.  More work must be done on this issue. 

But, if you suffer from burning tongue, the question is do you also suffer from one or more of the symptoms of TMD/TMJ?  The answer may be a surprise.