New Hope for Burning Mouth Syndrome!

An article in the Brazilian Journal of Anesthesiology “Sphenopalatine ganglion block – a new treatment for burning mouth syndrome?” describes the use of Sphenopalatine Ganglion Blocks to treat Burning Mouth Syndrome. (Abstract below).

The procedure is a Sphenopalatine Ganglion Block which is delivered with a cotton tipped trans-nasal swab. This procedure was first discovered and published by Dr Greenfield Sluder in 1908. It is an extremely safe procedure with high efficacy for many conditions including headaches, migraines, cluster headaches, sinus headaches and many other disorders. I published a paper in 2019 on SPG Blocks.

The Sphenopalatine Ganglion (SPG) is also known as the Pterygopalatine Ganglion based on its location in the Pterygopalatine Fossa. The Sphenopalatine Ganglion (SPG) is the largest Parasympathetic Ganglion of the Cranium and is found in the pterygopalatine fossa and is on the Maxillary Division of the Trigeminal Nerve. Post-ganglionic fibers enter it from the superior cervical sympathetic chain. Fibers from the entire sympathetic cervical ganglion chain and from the Stellate Ganglion pass into the SPG and then travel on all the branches of the trigeminal Nerve which also goes to the cornea of the eye.

According to Mayo Clinic is: “Burning mouth syndrome is the medical term for ongoing (chronic) or recurrent burning in the mouth without an obvious cause. This discomfort may affect the tongue, gums, lips, inside your mouth and cheeks, roof of your mouth (palate) or widespread areas of your whole mouth. The burning sensation can be severe, as if you scalded your mouth.

Burning mouth syndrome usually appears suddenly, but it can develop gradually over time. Unfortunately, the specific cause often can’t be determined. Although that makes treatment more challenging, working closely with your health care team can help you reduce symptoms.”

Sphenopalatine Ganglion Blocks are very safe and patients can learn SASPGB or Self-Administration of SphenoPalatine Ganglion Blocks with cotton-tipped nasal catheters. This is ideal for patients suffering from chronic pain. Most patients find they need to utilize SPG blocks less often over time.

Dr Sluder was the head of Otolaryngology at Washington University School of Medicine in St Louis and wrote a medical textbook, Nasal Neurology primarily focused on the Sphenopalatine Ganglion and the Trigeminal nerve connections.

“Miracles on Park Avenue” was a popular book by Benjamin Gerber published in 1986 that described the world-famous practice of Dr Milton Reder an Octogenerian ENT whose entire practice was use of SPG Blocks. Famous individuals came from world-wide for his treatments.

SPG Blocks can also be done with a Sphenocath device or a TX360 device by physicians. The use of SASPGB is the most convenient and cost-effective approach for most patients.

Burning mouth syndrome is a poorly understood entity for which current treatment modalities fail to provide effective relief. Branches of the maxillary and mandibular nerves are responsible for the innervation of the affected area. These are also the nerves involved in trigeminal neuralgia, an entity where sphenopalatine block has proved to be effective. We present a case of a patient with burning mouth syndrome in whom a bilateral sphenopalatine ganglion block was successfully performed for pain treatment. It is an easy and safe technique that can be a valuable treatment option for these patients, although more studies are needed.