Burning mouth syndrome
Make an Appointment
Talk to DoctorOverview
Burning mouth syndrome (BMS) is a medical condition characterized by persistent or recurring sensations of burning in the mouth or throat, with no apparent underlying cause. The discomfort can manifest in any part of the mouth and may resemble the sensation of being scalded by a hot liquid, such as coffee.
Individuals experiencing BMS often note that the burning sensation intensifies as the day progresses. While the mouth may feel normal upon waking, the discomfort tends to worsen later in the day. Interestingly, the pain may alleviate during sleep, only to restart the next day.
Accompanying the burning sensation, many individuals with BMS report a bitter or metallic taste in their mouths. Despite regular saliva flow, a sense of dryness is often experienced. In severe cases, the chronic pain associated with BMS can contribute to feelings of depression and anxiety.
Symptoms
Burning mouth syndrome does not result in any noticeable physical changes to the tongue or mouth. However, it might persist for months or even years, depending on the specific pattern of mouth irritation. Rarely, symptoms may disappear quickly or occur less frequently.
Burning mouth syndrome discomfort varies in pattern. It can occur daily, starting with mild discomfort in the morning and worsening throughout the day, persist all day from the moment of waking, or come and go unpredictably over time.
Symptoms include:
- A dry mouth sensation accompanied by increased thirst
- Diminished ability to taste
- Tingling, stinging, or numbness sensations in the mouth
- A sensation of burning or scalding, typically impacting the tongue but potentially extending to the lips, gums, roof of the mouth, throat, or the entire oral cavity
- Changes in taste perception, including the presence of bitter or metallic tastes.
If any of the symptoms persist, consult a healthcare provider for proper diagnosis and treatment, especially in cases where there is a discomfort, burning, or soreness in the tongue, lips, gums, or other oral areas.
Untreated, burning mouth syndrome has the potential to persist for months or even years. Seeking timely medical attention is crucial for addressing and managing this condition.
Causes
Primary burning mouth syndrome:
When the cause cannot be identified, the condition is termed primary or idiopathic burning mouth syndrome. Current research suggests that primary burning mouth syndrome may be associated with nerve issues related to taste and pain.
Secondary burning mouth syndrome:
In certain instances, burning mouth syndrome is triggered by an underlying medical condition, leading to what is known as secondary burning mouth syndrome.
Underlying Factors Associated with Secondary Burning Mouth Syndrome:
- Dry mouth: Resulting from medications, health issues, salivary gland problems, or side effects of cancer treatment.
- Other oral conditions: Including oral thrush (fungal infection), oral lichen planus (inflammatory condition), or geographic tongue.
- Nutritional deficiencies: Insufficient intake of iron, zinc, folate (vitamin B-9), thiamin (vitamin B-1), riboflavin (vitamin B-2), pyridoxine (vitamin B-6), and cobalamin (vitamin B-12).
- Allergies or reactions: To foods, food additives, flavorings, fragrances, dyes, dental materials, or oral care products.
- Gastroesophageal reflux disease (GERD): Stomach acid reflux into the mouth.
- Medication side effects: Especially with certain high blood pressure medications.
- Oral habits: Such as tongue pushing, tongue biting, teeth grinding, or clenching.
- Endocrine disorders: Like diabetes or hypothyroidism (underactive thyroid).
- Irritated mouth: Resulting from excessive tongue brushing, abrasive toothpaste use, overuse of mouthwashes, acidic foods/drinks, or ill-fitting dentures.
- Psychological factors: Anxiety, depression, or stress.
Risk factors
Burning mouth syndrome is a relatively uncommon condition. It typically manifests suddenly and without a discernible cause. An increased risk of this condition is observed in individuals over the age of 50, females, particularly those in perimenopause or postmenopausal stages, and smokers.
Another contributing factor to the higher likelihood BMS in women is their taste sensitivity. The variations in people’s genetic makeup result in differences in their ability to taste.
Other risk factors include:
- Food allergies
- Emotional stress or tension
- Anxiety
- Depression
- Recent sickness
- Certain chronic health conditions like fibromyalgia, Parkinson’s disease, autoimmune disorders, and neuropathy
- Past dental procedures
- Traumatic life experiences
- Specific medications
Diagnosis
Diagnosing burning mouth syndrome involves a process of elimination, involving the exclusion of other conditions with similar symptoms, such as oral yeast infections like thrush. There is no single definitive test for BMS.
The diagnosis often involves review of medical history and medications, examination of the mouth, and assessment of symptoms, oral hygiene habits, and routines. Seeking initial consultation with a dentist is recommended for those experiencing symptoms, as one-third of BMS cases are attributed to oral health issues.
A medical examination is likely to be conducted to identify signs of other underlying conditions. Necessary tests include:
- Blood tests: The findings of the test may provide information on what’s causing mouth pain. The immune system’s function, thyroid function, blood sugar level, nutritional status, and full blood count can all be assessed with these tests.
- Allergy tests: Allergies to specific foods, additives, or even materials used in dental procedures or oral care products is identified during this test.
Salivary flow test: Due to the sensation of dryness associated with burning mouth syndrome, tests measuring salivary flow can indicate if there is a reduction in saliva production. - Oral cultures or biopsies: During a biopsy, small bits of tissue are removed from the mouth for laboratory analysis. For oral culture, a sample is collected from the mouth using a cotton swab. This can determine whether the oral cavity is infected with bacteria, viruses, or fungi.
Gastric reflux tests: Regurgitation of stomach acid into the mouth is detected through this test.
Imaging: To investigate potential underlying health issues, imaging procedures such as a magnetic resonance imaging (MRI) or computed tomography (CT) scan may be suggested. - Modification of prescribed drugs: Adjusting the dosage, switching to another medicine, or temporarily stopping the medication may be recommended in cases where the medication causes mouth discomfort.
- Mental health questions: Symptoms indicative of depression, anxiety, or other mental health conditions that could be connected to burning mouth syndrome may require further assessment through a designed questionnaire.
Treatment
Primary Burning Mouth Syndrome
There is currently no known cure for primary burning mouth syndrome, and effective treatment methods vary. Due to limited research, finding the most suitable approach may require experimentation. Managing symptoms is the primary goal, and it may take time to identify a successful treatment or combination.
Treatment options:
- Saliva replacement products: To alleviate dry mouth symptoms.
- Specific oral rinses or lidocaine: Providing numbness for pain relief.
- Capsaicin: A pain reliever derived from chili peppers.
- Alpha-Lipoic Acid: An antioxidant that may help relieve nerve pain.
- Clonazepam (klonopin): A medication used to control seizures.
- Antidepressants: Specifically chosen based on symptoms.
- Medications blocking nerve pain: Targeting pain receptors.
- Cognitive behavioral therapy (CBT): Developing practical skills to address anxiety, depression, stress, and pain management.
Secondary Burning Mouth Syndrome
For secondary burning mouth syndrome, treatment hinges on addressing underlying conditions contributing to mouth discomfort.
- Identify the cause: Determine and address the root cause, such as oral infections or vitamin deficiencies.
- Treatment of underlying conditions: Administer appropriate treatments, such as antibiotics for infections or supplements for nutritional deficiencies.
- Symptom relief: Alleviate burning mouth syndrome symptoms by resolving the underlying issues.
Understanding the specific type and cause of burning mouth syndrome is crucial in tailoring an effective treatment plan. Once underlying causes are treated, improvements in burning mouth syndrome symptoms are expected.
