Burning Mouth Syndrome: Causes, Symptoms & Treatment

Burning mouth syndrome is a condition referring to an ongoing or recurring burning sensation in the mouth without an obvious cause. It can be chronic, everyday problem, or it may occur periodically.

You may feel this burning on the tongue, gums, lips, inside of the cheeks, roof of the mouth or large areas of the whole mouth. This feeling of burning can be severe, as if you injured your mouth with a very hot drink or fluid.

People with this condition reports a bitter or metallic taste often happens along with the burning sensation. Some also feel a dry mouth despite having regular saliva flow. Sometimes, the burning is so severe that the chronic pain from it causes depression and anxiety.

Study shows this syndrome occurs in about 2% of the population. Women are more likely than men to be diagnosed with this condition. According to American Academy of Oral Medicine

Symptoms of burning mouth syndrome

The symptoms of burning mouth can be mild or severe, and vary from person to person. These can include:

• A feeling of dry mouth with increased thirst.
• A burning or scalding feeling that most commonly affects your tongue, but also may affect your lips, gums, roof of your mouth, throat or whole mouth.
• Taste changes in your mouth, such as a bitter or metallic taste.
• Tingling, stinging or numbness in your mouth.
• Loss of taste.

The effect from burning mouth can have several different patterns. It might:

• Start as soon as you wake up and last all day.
• Come and go.
• Happen every day, with little discomfort when waking up, but become worse as the day goes on.

It usually doesn’t cause any physical changes to your tongue or mouth that can be seen. The symptoms can last for a lengthy period of time. Facing the challenges of burning mouth with constant mouth pain for days, weeks, months, or years can make it difficult to eat or drink, though some people reports they experience relief after eating and drinking. If you are having any of the above symptoms and experience a lot of discomfort, you should seek a medical attention immediately.

Types of burning mouth syndrome

This condition is categorized into two, which include:

• Primary burning mouth syndrome. When the cause can’t be found, the condition is called primary or idiopathic burning mouth syndrome
• Secondary burning mouth syndrome. This can be linked to several Underlying medical problems or conditions.

Causes of burning mouth syndrome

In primary burning mouth syndrome (idiopathic). Some research suggests that, it is related to problems with the nerves involved with taste and pain.

While the secondary burning mouth syndrome has to do with several underlying medical conditions or problems which include:

• Not getting enough nutrients. This is when you lack nutrients such as iron, zinc, folate (vitamin B-9), thiamin (vitamin B-1), riboflavin (vitamin B-2), pyridoxine (vitamin B-6) and cobalamin (vitamin B-12).
• Dry mouth. This can be caused by some medicines, health problems, problems with the glands that make saliva or the side effects of cancer treatment.
• Other oral conditions. This can include a fungal infection of the mouth called oral thrush, an inflammatory condition called oral lichen planus or a condition called geographic tongue that gives the tongue a maplike appearance.
• Allergies or reactions to foods. Food flavorings, other food additives, fragrances or dyes, dental materials, or mouth care products.
• Reflux of stomach acid. This is when reflux of stomach acid enters your mouth from your stomach, also called gastroesophageal reflux disease (GERD).
• Certain medicines. Medications linked to BMS include ACE inhibitors for hypertension, some antidepressants and high blood pressure medications, such as Clonazepam, Fluoxetine, Captopril and more.
• Oral habits. Habits such as pushing your tongue against your teeth, biting the tip of your tongue, and grinding or clenching your teeth.
• Endocrine disorders. This can be diabetes or an underactive thyroid known as hypothyroidism.
• A very irritated mouth. This may result from brushing your tongue too much or too hard, using abrasive toothpastes, overusing mouthwashes, or having too many acidic foods or drinks. Dentures that don’t fit well may cause irritation that can make symptoms worse.
• Psychological issues. This is rare and can include anxiety, depression or chronic stress.

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Risk factors of burning mouth syndrome

Burning mouth syndrome is a rare condition, however your risk of having it can be greater if you are a female, in perimenopause or you’re postmenopausal, close to the age of 50 or over and also being a smoker.

Other risk factors may include:

• Previous dental work.
• Recent illness.
• Some long-term medical conditions such as fibromyalgia, Parkinson’s disease, autoimmune disorders and neuropathy.
• Certain medicines.
• Allergic reactions to food.
• Traumatic life events.
• Anxiety.
• Depression.
• Stress.

Complications of burning mouth syndrome

The effect from burning mouth condition can result in discomfort such as difficulty falling asleep or eating. A chronic and severe effects from this condition can lead to depression or anxiety.

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Prevention of burning mouth syndrome

There’s no best way to prevent this condition, but you can lower your symptoms by limiting or avoiding anything that irritates your mouth or tongue, which might include:

• Hot and spicy foods or drinks.
• Alcohol.
• Tobacco products.
• Mouthwash containing alcohol.
• High-acidic foods or drinks (like citrus juices).

Another thing that can help is getting enough vitamins and nutrients.

Diagnosis of burning mouth syndrome

The diagnosis can be difficult and often a matter of exclusion especially if it’s primary burning mouth syndrome. But if it’s secondary burning mouth syndrome, your healthcare provider will try to rule out problems or underlying conditions causing it, by performing physical examination and asking about your medical history.

The following are some of the tests to diagnose the underlying conditions causing burning mouth:

• Blood tests.
• Allergy tests.
• Imaging tests.
• Salivary flow test.
• Oral swab tests.
• Tissue biopsy.

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Treatment of burning mouth syndrome

There’s no known best way to treat primary burning mouth syndrome. And there’s no one sure way to cure it. The research on treatment methods and specific medications are still ongoing.

The treatment depends on what symptoms you are having and the aim in controlling them. You may need to try several treatments before finding one or a combination that helps reduce your mouth discomfort, this is best recommended by your healthcare provider. And it may take time for treatments to help manage your symptoms.

Some of the treatments options from healthcare professionals include:

• Specific oral rinses or lidocaine, which causes numbness to help relieve pain.
• Saliva replacement products.
• Capsaicin, a pain reliever that comes from chili peppers.
• Alpha-lipoic acid, an antioxidant that may help relieve nerve pain.
• Certain antidepressants.
• Cognitive behavioral therapy to develop practical skills to address anxiety and depression, deal with stress, and cope with ongoing pain.

On the other hand if you have secondary burning mouth syndrome, treatment involves treating the underlying health problem or conditions. Some of these can include:

• Dry mouth. If you have dry mouth, ask your healthcare provider about products to increase saliva production, or take vitamin shots or supplements for a vitamin deficiency.
• Acid reflux: Medication to neutralize stomach acid may help relieve your symptoms, like (antacids).
• Mouth infection: Your healthcare provider can also prescribe medication to treat an underlying oral infection, or a pain reliever. And can even refer you to a specialist or dentist.

Without the treatment of burning mouth, it can last for months or even years. About one-third of those with burning mouth will improve over three to five years without any treatment. The treatment of burning mouth syndrome can provide relief within few days or weeks. Discuss with your doctor about the best treatment option and when you can expect to improve and feel better.

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