Burning Mouth Syndrome (BMS) is a condition characterized by a burning sensation in the mouth. It often appears to develop without any obvious cause, and the symptoms may come and go.
Burning Mouth Syndrome is characterized by a burning sensation on the tongue, palate, lips, or other areas of the mouth and throat. These sensations are similar to those experienced after burning the tongue with a hot liquid such as coffee.
The burning sensation may intensify throughout the day. A person may wake up without any discomfort, but the burning sensation develops later during the day. After sleep, the discomfort may decrease. However, the cycle often begins again the following day.
Along with the burning sensation, a bitter or metallic taste may develop in the mouth. Many people also experience dry mouth despite normal saliva production. In some cases, the burning sensation can become so severe that it contributes to anxiety and depression.
Types of Burning Mouth Syndrome
There are two types of Burning Mouth Syndrome.
Primary Burning Mouth Syndrome occurs when the burning sensation is not caused by an underlying medical condition.
Secondary Burning Mouth Syndrome is caused by an underlying condition, such as acid reflux. Treating the underlying condition often resolves the burning symptoms.
Who Is Most Commonly Affected by Burning Mouth Syndrome?
Burning Mouth Syndrome is most commonly observed in people over the age of 60. This may be related to reduced estrogen levels, which can decrease the sensitivity of taste receptors.
Another risk factor is an individual’s ability to perceive taste. People have genetic differences in their taste sensitivity. In the 1990s, Professor Linda Bartoshuk of Yale University developed a test that classified individuals as supertasters, medium tasters, and non-tasters according to the concentration and sensitivity of their taste receptors. Later, these terms evolved into the more precise classifications of hyper-tasters and hypo-tasters.
Hyper-tasters have a high concentration of taste receptors and are highly sensitive to flavors and textures. Women are twice as likely as men to be hyper-tasters.
Hypo-tasters have a lower concentration of taste receptors and can distinguish only strong and intense flavors.
Most women with Burning Mouth Syndrome are hyper-tasters who have lost part of their taste perception. Research suggests that many of these individuals also clench their teeth. Pressure on the teeth may intensify the burning sensation.
Burning sensations in the mouth are also common in individuals with a condition known as geographic tongue. In this harmless condition, red patches appear on the surface of the tongue.
Symptoms
Symptoms of Burning Mouth Syndrome may include:
- oral pain described as tingling, scalding, or burning;
- numbness in the mouth;
- changes in taste perception;
- dry mouth.
What Is the Main Cause of Primary Burning Mouth Syndrome?
Researchers believe that primary Burning Mouth Syndrome is caused by nerve damage affecting the part of the tongue responsible for taste and pain sensation.
There appears to be a relationship between burning sensations and taste disturbances.
Many people who experience burning in the mouth have lost bitter taste receptors located at the tip of the tongue. Researchers believe that when people lose the ability to perceive bitter tastes, pain signals may develop that are interpreted as a burning sensation in the mouth.
What Causes Secondary Burning Mouth Syndrome?
Medical conditions that may cause secondary Burning Mouth Syndrome include:
- acid reflux;
- allergies to metal dental restorations or certain foods;
- depression;
- dry mouth;
- hormonal changes;
- oral infections;
- nutritional deficiencies resulting from inadequate dietary intake;
- teeth grinding or jaw clenching.
People with Sjögren’s syndrome, which causes dry mouth and dry eyes, diabetes, thyroid disorders, and liver disease may also develop Burning Mouth Syndrome.
In addition, certain medications used to treat high blood pressure, antidepressants, and hormone replacement therapy may trigger symptoms.
Deficiencies of vitamin B12, folic acid, or iron can sometimes mimic the symptoms of Burning Mouth Syndrome.
Diagnostics
Burning Mouth Syndrome can be difficult to diagnose. There is no single test that can confirm whether a patient has BMS.
Part of the diagnostic process involves ruling out other conditions that may cause similar symptoms, such as oral candidiasis (thrush).
If you experience symptoms, you should first consult a dentist. Oral health problems account for approximately one-third of all Burning Mouth Syndrome cases. If necessary, the dentist may refer you to another specialist.
To help establish a diagnosis, your healthcare provider may recommend:
- allergy testing;
- blood tests;
- oral swab testing;
- measurement of salivary flow;
- tissue biopsy.
Treatment
Certain medications may help manage the symptoms of Burning Mouth Syndrome. Although the U.S. Food and Drug Administration (FDA) has not approved any medication specifically for the treatment of BMS, healthcare providers may prescribe certain drugs to relieve symptoms.
These may include antidepressants, anticonvulsants, and other medications. However, only a physician can determine which treatment is most appropriate.
If the syndrome is caused by teeth grinding or jaw clenching, dental treatment may help resolve the problem.
When an underlying medical condition is responsible for the symptoms, treating that condition should help eliminate the burning sensation.
If medications are causing oral discomfort, your physician may adjust the dosage or prescribe an alternative medication. In some cases, temporarily discontinuing a medication under medical supervision may help determine whether it is contributing to the symptoms.
Never stop taking prescribed medication on your own, as doing so may be dangerous.
Prevention
There is likely no reliable way to prevent Burning Mouth Syndrome completely.
However, symptoms may be reduced by avoiding factors that irritate the mouth, including:
- alcohol;
- foods and beverages with high acidity, such as citrus juices;
- hot and spicy foods or drinks;
- mouth rinses containing alcohol;
- tobacco products.
It is also important to ensure that your diet contains adequate amounts of vitamin B12, folic acid, and iron.
Maintain good oral hygiene and keep your teeth and mouth clean.
This article does not replace a medical consultation. For complete and personalized information, please consult your dentist.