Dental and Oral Health (Adults)

Is my mouth guard the problem?

04/16/2007

Question:

Thank you for addressing my questions.
Last year, a sleep specialist created a night mouth guard for me to help with several problems I have: TMJ, teeth grinding, headaches and snoring which wakes me up many times during the night. I never liked the appliance because it is one that fits into both the top and bottom teeth and is a total monstrosity in my mouth. I didn`t wear it because it was so uncomfortable and it felt like my mouth was full of marbles.
I am a snorer and finally had to resort to wearing it because my boyfriend was up all night if I didn`t. It definitely stops my snoring, which is good. I noticed about the first week of wearing it that I felt more refreshed in the morning, so, I started wearing it every night for the last couple weeks because I figured it was allowing me to actually sleep through the night without being awakened from my own snoring. Now, for the last week or so I wake up fine but by mid day I am about ready to collapse I`m so tired. I realize there are many different possible reasons for that, but, I`m wondering if it could also be related to my main concern, which is...
Due to the construction of the mouth guard it is near impossible for me to produce saliva. My tongue and lips and overall mouth get so dry during the night since I know my mouth naturally falls open during the night and I am breathing through my mouth as well as my nose. I keep a glass of water next to my bed but its a very temporary fix. I`m now wondering how times I`m being awaken during the night, not from my snoring, but from my mouth being so dry. My lips are now cracked and painful on one corner of my mouth and are not healing and I am experiencing several different problems with my tongue.
1. For the last week or so my mouth has had a bad taste like it would when I have a cold - where I want to drink or eat something or brush my teeth to get rid of the taste, but it doesn`t go away. It is primarily in the back of my mouth.
2. My tongue has been extremely sensitive to anything I eat that has any type of spice or seasoning (salt, garlic, etc.). Mild salsa now tastes like hot and spicy salsa. Salt makes my tongue burn. Even when not eating, it just feels like I burned my tongue from eating something too hot, like I sometimes do to the roof of my mouth if I eat pizza when its too hot.
3. Breaking my mouth down to three specific regions - front, middle and back - I will describe my symptoms. I am only experiencing these symptoms on the top of my tongue.
a. I have an overall feeling of having burned my tongue in the front and back sections
b. The front section appears a little more red than the rest. On the tip of my tongue are a bunch of tiny little red bumps. There are also random red, raised tastebuds in the front and back sections of my tongue. All are sensitive to the touch. I have one little patch of tiny raised tastebuds, some of which are white and some of which are red. These are sensitive to the touch.
c. The center of my tongue is very smooth and I don`t have any type of sensitivity on the surface.
d. The back of my tongue is really rough w/all my tastebuds raised and hard. I also have a yellowish film on the back surface.
I should also tell you that I have been smoking daily for the last year - probably a pack a week.
I realize the only way to get an accurate diagnosis is to see a doctor and I am going to see an ENT in 5 days. In the meantime, however, it is driving me crazy trying to figure out if it is from my mouth guard or the smoking. Cigarettes now taste absolutely disgusting - which is good because I AM going to quit. I`m afraid I have tongue cancer or something. Any initial thoughts you have I would really appreciate.

Answer:

You describe so many different problems that it is impossible for me to sort out everything without the benefit of a clinical examination of your condition(s).

Many of your symptoms could be related to decreased saliva production but it is important to rule out the influence of any medications you may be using. One of the most common side effects of drugs is xerostomia or dry mouth. Smoking also tends to the dry out the oral cavity. If the mouth is dry, the tisues can become more susceptible to yeast or fungal infection. The microorganisms can build up on the mouth guard as well, so this needs to be cleaned carefully with a toothbrush every day and some patients soak them in commercially-available mouthwash solutions. If there is any question about an oral yeast infection, a cytology smear or a culture from the tongue or from the mouth guard itself can be useful.

Some of your symptoms are also similar to those seen with the condition known as burning mouth syndrome (BMS). Please see the link below.

I hope that this information is helpful to you and your ENT physician. Good luck!

Related Resources:

Burning Mouth Syndrome

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Response by:

John R. Kalmar, DMD, PhD
Professor and Graduate Program Director
Dental Faculty Practice
Section of Oral and Maxillofacial Pathology
College of Dentistry
The Ohio State University