Gerald S. Fine, D.D.S.

   Oral and Maxillofacial Surgery

Brookline Office
Tel: 617-731-6060

Our commitment is to provide you the highest standard of oral and maxillofacial surgery in a professional manner.

Scalded Mouth Syndrome

Several weeks ago I saw a 68 year old woman who was referred to my office by a physician for an evaluation. She had been complaining of a "burning sensation" on the tongue and lip followed by mucosa peeling. The physician had treated her symptoms with antifungal therapy without success.

The patient's past medical history was significant for hypertension which was being treated for the past year with enalapril (Vasotec). I suggested her medication be changed ( it was changed to Acupril) and her symptoms disappeared. Although uncommon, this is the second case of Scalded Mouth Syndrome ( S. M. S.) I have seen. Last year a 57 year old male was seen in my office with a complaint of a painful tongue. Clinical examination revealed no lesions at the site. His past medical history was significant for hypertension for which he was taking nadalol (Corgard) and prior had been taking captopril (Capoten). After discussion with his physician, it was decided to initiate another antihypertensive and to discontinue his Capoten. The patient's symptoms disappeared within one week.

Scalded Mouth Syndrome (SMS) is rare; but becoming more common with significant numbers of patient's being treated for hypertension with Angiotension Converting Enzyme (ACE) inhibitors, such as captopril, enalapril, and lisinopril. Scalded Mouth Syndrome is marked by a burning sensation of the oropharyngeal soft tissue that is not accompanied by any clinical signs.

Adverse reactions to captopril include taste impairment on about 7% of patients taking more than 150 mg/day. ACE inhibitors can induce oral and cutaneous lichen planus. A differential diagnosis should include Sjorgren's syndrome, burning mouth syndrome, candidiasis, discoid lupus erythematosus and psychogenic pain.

‍Gerald S. Fine, D.D.S.
Practice limited to oral & maxillofacial surgery‍