What Is Burning Mouth Syndrome?

Feeling a burning or stinging sensation can be concerning, especially if you don’t think anything is wrong with you. 

This condition is known as burning mouth syndrome (BMS), and it affects 1 to 3% of adults, especially post-menopausal women. 

Fortunately, BMS isn’t caused by visible burns or infections. Learn more about this condition here.

What is Burning Mouth Syndrome?

BMS, also known as stomatodynia or glossodynia, causes chronic pain inside the mouth. People with BMS also commonly experience a foul taste or dry mouth. 

While it’s common among post-menopausal women, men can also experience it. The condition isn’t fully understood, and there’s no specific treatment for it.

Fortunately, BMS isn’t life-threatening, but it can lead to related problems such as sleep disturbance, anxiety, depression, and reduced quality of life.

What Does Burning Mouth Syndrome Feel Like?

Burning mouth syndrome creates discomfort without any visible injuries. Common experiences include stinging, tingling sensations, and persistent dry mouth.

You might also notice changes to your taste buds, causing a metallic or bitter taste. The pain from BMS often intensifies throughout the day, peaking by afternoon or evening.

Some people describe it as sipping hot coffee or biting into spicy peppers. Unlike other mouth problems, BMS leaves no physical marks.

What are the Symptoms of Burning Mouth Syndrome?

If you have burning mouth syndrome, you may notice the following: 

• Burning or stinging feeling in the tongue, palate, lips, or entire mouth
• Dry mouth sensation
• Increased thirst
• Loss of taste or altered taste
• A bitter or metallic taste in the mouth
• Tingling or numbness in the mouth

These symptoms may vary throughout the day. They may get worse with stress or fatigue. Some people with BMS notice decreased pain when they eat, drink, or go to bed.

Pain and other BMS symptoms can last for years. However, they sometimes improve over time; for some, the symptoms may resolve on their own.

What Causes Burning Mouth Syndrome?

Some research suggests that people with a higher density of taste buds (often called “supertasters”) may have an increased risk of BMS, but the evidence is not yet conclusive. Post-menopausal women remain the group most frequently affected.

Additionally, people with chronic anxiety or high levels of stress can experience BMS more frequently. This is because anxiety and stress can affect how people perceive pain.

BMS is often caused by several underlying factors, including:

• Systemic factors — Nutritional deficiencies in vitamin B and iron, diabetes, or thyroid imbalances, can cause mouth burning. These issues disrupt the normal function of oral tissues and nerves, contributing to discomfort.
• Hormonal shifts — Women frequently experience BMS around menopause due to dropping estrogen levels.
• Medication — Some medications, especially ACE inhibitors (used for blood pressure) and certain antidepressants, can trigger burning mouth. 
• Lifestyle choices — Smoking or using alcohol-based mouth rinses can contribute to BMS symptoms.
• Neuropathic pathway — BMS often involves nerve damage, specifically affecting small nerve fibers. These damaged nerves send abnormal pain signals, making your mouth feel persistently hot or tingly without visible injury.

Secondary Burning Mouth Syndrome 

Secondary BMS refers to burning mouth pain caused by another underlying medical condition. Some conditions that can cause BMS symptoms include:

• Oral thrush (candidiasis), an oral yeast infection
• Other fungal or bacterial mouth infections
• Inflammatory conditions like oral lichen planus and geographic tongue
• A nutritional deficiency, such as folate, vitamin B12, vitamin C, iron, and/or zinc
• Allergies
• Diabetes
• Acid reflux (GERD)

If you notice visible changes to your mouth or tongue besides BMS symptoms, you likely don’t have “true” or primary BMS. You may have one of the conditions listed above.

However, you might have an underlying condition even if you don’t notice any other symptoms. See your dentist for an examination to get the treatment you need.

How is BMS Treated?

There’s no specific treatment for BMS. If you have secondary BMS, treating the underlying condition should cure your symptoms.

For primary BMS, various treatment methods have shown some success, including:

• Topical medications, such as capsaicin (the active chemical in hot peppers), can relieve nerve pain
• Medications like clonazepam, gabapentin, and certain antidepressants
• Nutritional supplements, such as vitamin B, iron, and zinc
• Hormone replacement therapy (estrogen for menopausal or postmenopausal women)
• Psychotherapy to help with stress, anxiety, and pain perception

At-Home Treatment Options

You may also be able to relieve BMS symptoms by doing the following:

• Suck on ice or eat something cold.
• Chew sugar-free gum to stimulate saliva production.
• Avoid spicy and acidic foods.
• Avoid tobacco and alcohol.
• Use non-alcoholic mouthwash.

How is Burning Mouth Syndrome Diagnosed?

If you have BMS symptoms, see a dentist. They can examine your mouth and compare your symptoms to other known conditions. 

They may even refer you to another specialist. To diagnose BMS, your dentist may do the following:

• Get a complete account of your symptoms, how they started, and overall mental and physical well-being.
• Visually examine your mouth and tongue.
• Perform imaging tests, such as X-rays or CT scans.
• Test your saliva flow.
• Conduct blood, oral swab, and allergy tests.
• Get a tissue biopsy.

Can You Prevent BMS?

There is no clear way to prevent BMS. However, it may help to:

• Reduce or manage stress and anxiety with healthy relationships, exercise, and meditation.
• Keep a balanced diet high in vitamins and minerals.
• Maintain good oral hygiene.
• Stay away from any foods you know you are allergic to.