Authors: Priyanka Mohanty, Hanna Bobrysheva, Astha Patel, Omar A Bajwa, Waheed K Bajwa MD.
Burning mouth syndrome (BMS) is a complex condition that is characterized as a recurrent burning or scalding sensation in the mouth. The cause of BMS is unknown, and there have not been any universally effective treatments. The current report presents the case of a 58-year old man whose onset of burning mouth syndrome triggered moderate major depressive disorder and generalized anxiety disorder. The patient lost approximately 50 pounds over the course of one year and his self-esteem was lowered, however his psychiatric symptoms were magnified following a deep scale dental cleaning. The patient underwent treatment in the clinic for approximately 6 months; his treatment consisted of medication management and psychotherapy. After inadequate medication response, he was eventually recommended for pharmacogenomic testing. The test indicated that the patient was heterozygous for the C677T polymorphism in the MTHFR gene which is associated with reduced folic acid metabolism. Following supplementation of folic acid and B12, as well as treatment with antidepressants, the patient showed improved symptoms of depression and anxiety. It was noted that during his treatment, the patient’s burning mouth syndrome was in turn stabilized and he gained back any lost weight. This case report adds to the ongoing literature on effective burning mouth syndrome treatment as well as its psychiatric implications.
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