Eugenol, Nerve Injections, and BMS

Dental Injection

(c) Can Stock Photo / Nejron

A recent literature review article stated researchers were connecting eugenol and other dental pain relievers, nerve injections, and possible damage to the lingual nerve with Burning Mouth Syndrome. Take a look and see what you think, but I have long suspected a link between dental work, oral surgery, and eventual extraction of my front teeth to the resultant burning mouth pain I have suffered for over a decade.

This is not, of course, the only cause possible. There are many people with BMS who have not had dental work done near the time of onset and so other factors must be in play.

When I read this, I looked up eugenol because I had never heard of it. To my surprise, I found it is found in clove oil, cinnamon, nutmeg, and bay leaf but by far the most common use of it is in dental work. When eugenol is used in dental preparations such as surgical pastes, dental packing, and dental cement, it may cause contact stomatitis (cutaneous lesions) and allergic cheilitis (inflammation of the lips). The allergy can be discovered via a patch test. 

I do not recall ever having an allergy patch test done by any of my dentists or other specialists. If you suspect it might be a culprit in your BMS, it is worth asking about.

The reason this became relevant to me is that although I tolerated the recent replacement of a broken crown because it had a root canal and required no anesthesia, the consult visit to the endodontist turned up an interesting tidbit. In his opinion, which he sent to my dentist, saying that he did not think the root canal needed to be re-done, he indicated that he suspected my burning mouth pain may have been caused by an allergy to the nerve anesthetics used in the various procedures I had before the onset of this bout of BMS.

Interesting, indeed, and this was something that had not been suggested before.

The relevancy becomes urgency as I contemplate the next dental work that I will very likely need in the next couple of years. It is a lower molar crown that has lost its porcelain coating and is becoming increasingly temperature sensitive. Needless to say, it has not had a root canal and would probably either require one if the tooth degrades or at the very least, would require pain blocking to have the crown replaced. Either option means nerve injections of dental anesthetic and I shudder at the thought.

The last time I had root canals (in two molars), it caused a flare-up of my BMS pain that lasted nearly two years.

There are not any additional medications I have found to handle a flare-up, even though the Klonopin/Clonazepam works well for my normal levels of pain.

What do you do when faced with impossible choices?

You do what you must, then deal with the results with coping strategies and medicines.

 

Burning Mouth and the Humorous Pain Chart

A friend shared this image today on her Facebook page.

It caught my eye because as chronic pain sufferers, we get asked about our pain level all of the time by a variety of specialists. Burning Mouth Syndrome is a novelty to some doctors we encounter, and a pain chart helps to accurately convey the level of pain you experience and how it affects or inhibits your daily activities. Often it is a range, and with BMS, this is particularly true because our pain escalates throughout the day unless we find coping strategies or a medicine that provides some intervention.

This “improved” version adds a bit of humor to the pain scale (bees, bears and ninjas?), but also makes the point that if you are truly at the top-level of pain (10 is the top!) then you are incapacitated or have been rendered unconscious by the level of pain and medical intervention is required immediately.

I was surprised by the comments that accompanied the image. Some laughed, but others were angry, feeling that the image was mocking their pain. Some even took the scale to task for not having enough numbers, because their pain was “at least an 11 or 12!” Others berated the creator for not including labor, even though that is a pain that only affects one gender.

Pain is affected by many factors, and each person’s tolerance and perception is individual but we must be consistent and coherent when talking about our pain levels with medical professionals. Some of the comments came from people in the medical profession and they gently mocked people who claimed they were experiencing a 10 level of pain but were “casually talking on their phone and eating chips.” Continue reading

Gaming the Pain-Burning Mouth Syndrome

Pensive WomanIf you are here for information about Burning Mouth Syndrome (BMS) and my journey with it, you are in the right place.

I am continuing the information I shared in “A Pattern of Pain – Burning Mouth Syndrome, so feel free to read that post first if you haven’t already.

I outlined my experience with Klonopin/Clonazepam ODT Dissolving wafers and how much better they seemed to manage my pain. This is still the case, but I wish I could tell you that I was completely out of pain, or better yet, in remission. Neither is true, unfortunately. I have good days and bad days, but fewer bad days than I used to.

A couple of months ago, I became curious about these bad days. They had become more sporadic, but why? What was different on those days that made my usual therapy nearly ineffective? Continue reading

The Pity Party-Burning Mouth Syndrome

holohololand

Image courtesy of holohololand/FreeDigitalPhotos.net

I have been suffering from Burning Mouth Syndrome for nearly six and a half years now.

Every once in a while, what my Neurologist euphemistically refers to as “the persistence of it” overwhelms me and I have a brief, but intense pity party. Continue reading