Burning Mouth Syndrome, Glossodynia

Overview

Burning mouth syndrome (BMS), or glossodynia, manifests as a sensation of burning in the tongue, mouth roof, or lips, and can occur in various oral and throat areas. It may develop suddenly or gradually over time. Those with BMS often notice the burning sensation worsening as the day progresses, akin to being scalded by a hot drink. Additionally, individuals may experience a bitter or metallic taste.

The pain typically subsides during sleep but returns the next day, establishing a recurring pattern. Despite adequate saliva production, many sufferers report a persistently dry mouth. In severe cases, the constant pain may lead to feelings of depression and anxiety.

Symptoms

Burning mouth syndrome can persist for months to years, but in rare instances, symptoms may spontaneously improve or occur less frequently. Temporary relief from the burning sensation may occur during eating or drinking.

Burning mouth syndrome can cause discomfort in various ways. It might occur daily, starting with mild discomfort in the morning but worsening as the day progresses. Alternatively, it could begin as soon as one wakes up and last throughout the entire day. Some people may experience the discomfort coming and going intermittently.

Burning mouth syndrome does not result in observable physical changes to the tongue or mouth. Common symptoms include:

• A scorching or searing sensation that might impact the lips, gums, roof of the mouth or throat, or entire mouth, but it usually affects the tongue
• Mouth numbness that comes and goes
• Loss or altered taste, such as a metallic or bitter taste
• A dry mouth sensation accompanied by increased thirst

If any of the signs and symptoms persist, consult a healthcare provider for proper diagnosis and treatment. It may be necessary to identify the underlying cause especially when an individual is experiencing discomfort, burning, or soreness in their tongue, lips, gums, or other areas of the mouth.

Causes

Burning mouth syndrome have several potential causes. It is often categorized into two:

• Primary burning mouth syndrome: Primary burning mouth syndrome is believed to result from nerve damage that impacts the tongue’s taste and pain control area. Researchers suggest that the ability to taste bitter flavors normally inhibits pain, but when this is compromised, pain fibers may unexpectedly activate, leading to a burning sensation in the mouth for those affected. This type of BMS is also known as idiopathic burning mouth syndrome in which the illness is diagnosed but the underlying cause is unknown.
• Secondary burning mouth syndrome: An underlying medical problem may occasionally be the cause of burning mouth syndrome, such as:
  • Dry mouth: Side effects of cancer treatment, medications, health issues, and gland-related problems affecting saliva production are among the factors that can cause dry mouth.
  • Oral habits: Clenching or grinding the teeth, biting the tip of the tongue, and pressing the tongue on the teeth are examples of oral habits that can cause BMS.
  • Extremely irritated mouth: Ill-fitting dentures can contribute to irritation, exacerbating symptoms. Aggressive tongue brushing, the use of abrasive toothpaste, overreliance on mouthwashes, or consuming an excess of acidic foods or beverages can lead to excessive irritation in the mouth.
  • Other oral health disorders: This include geographic tongue, which causes the tongue to resemble a map, oral lichen planus, an inflammatory disease, and oral thrush, a fungal infection of the mouth.
  • Acid reflux: Also known as gastroesophageal reflux disease (GERD), this condition causes stomach acid to escape from the stomach and enter the mouth.
  • Nutritional deficiency: A deficiency of vitamin B12, folate or iron can resemble the sensation of burning mouth.
  • Allergies: Allergic reactions in the oral cavity can stem from various sources, including metal dental products, specific foods, food flavorings, additives, fragrances, and dyes.
  • Psychological problems: This include stress, depression, or anxiety.
  • Certain drugs: BMS can be associated with certain medications, including ACE inhibitors used for hypertension, specific antidepressants like fluoxetine and sertraline, and high blood pressure medications such as captopril, clonazepam, efavirenz, and enalapril. Hormonal replacement therapies may also be linked to BMS.
  • Certain disorders: Conditions like Sjögren’s syndrome, characterized by dry mouth and dry eyes, as well as diabetes, thyroid disease, and liver problems can cause burning mouth syndrome.

Risk factors

Burning mouth syndrome often arises suddenly without an identifiable cause. However, certain factors may increase the risk of developing BMS, including being female and being a smoker. Women are particularly vulnerable to BMS due to their heightened sensitivity to taste.

BMS is also frequently observed in individuals over 60, especially in postmenopausal women, as decreased estrogen levels lead to reduced taste bud sensitivity.

Other risk factors include:

• Recent medical condition
• Food-related allergic responses
• A few chronic illnesses, including neuropathy, fibromyalgia, Parkinson’s disease, and autoimmune disorders
• Has geographic tongue, where red patches emerge on the tongue’s surface
• Past dental procedures
• Specific medications
• Difficult life experiences
• Tension, anxious feelings, and depressive states