What Is Burning Mouth Syndrome?

Key Takeaways

• Burning mouth syndrome (BMS) is a term for chronic burning or stinging pain in the mouth, which may come with other changes in taste or mouth sensations.
• BMS mainly affects females during or after menopause.
• Some conditions, such as oral thrush or geographic tongue, may cause burning mouth pain. The pain generally goes away once the underlying condition is treated.
• BMS generally refers to cases where there isn’t another clear cause for the pain.
• BMS is relatively rare, and experts are still learning about it. There is no definitive cure, but various treatments have been successful in helping people with BMS.

What is Burning Mouth Syndrome (BMS)?

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. 

The term is often used when there aren’t obvious signs of other conditions causing the symptoms. However, some known oral health conditions are associated with BMS.

This condition mainly affects females during and after menopause, but males can also experience it.¹ The condition isn’t fully understood by experts, and there is no specific treatment or cure.

Fortunately, BMS isn’t life-threatening and doesn’t necessarily cause other health problems. However, it can be difficult to manage and can have an impact on your quality of life. 

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. 

Types of Burning Mouth Syndrome

BMS can be divided into two types. Primary BMS occurs on its own, while in secondary BMS, the burning pain can be linked to another condition.

Primary Burning Mouth Syndrome

Primary burning mouth syndrome refers to “true” BMS that isn’t linked to other medical or dental conditions. The condition is the burning pain itself.³

You’ll only be diagnosed with BMS if other possible causes have been ruled out. If your pain and other mouth symptoms result from another condition, treating that condition should make the symptoms go away, meaning you don’t have primary BMS.

What Causes Primary BMS?

Experts believe primary BMS may have to do with nerve damage and differences in pain perception.

Women experience hormonal changes during and after menopause, including a drop in estrogen levels. This can sometimes affect the way nerves perceive taste and other sensations.

Primary BMS may be more common in:

• Supertasters, who have more taste buds than the average person. Postmenopausal women who are supertasters may be especially affected by changes in taste perception.
• People with chronic anxiety or high levels of stress; these conditions can affect the way people perceive pain.

Secondary Burning Mouth Syndrome 

Secondary BMS refers to burning mouth pain with another underlying cause. 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)

How your oral pain is treated will depend on the cause. This makes it important for your dentist or doctor to diagnose the reason for your symptoms.

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.

Diagnosis

Diagnosing the cause of BMS symptoms is important. An actual diagnosis of BMS will only be made if there aren’t any other conditions causing the symptoms.

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

To arrive at a diagnosis, your dentist or another specialist may do the following:

• Get a complete account from you of your symptoms, how they started, and your 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

Treatment for Burning Mouth Syndrome

There is no specific treatment for BMS. If you have secondary BMS (BMS symptoms caused by another condition), 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

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

• Sucking on ice or eating something cold
• Chewing sugar-free gum to stimulate saliva production
• Avoiding spicy and acidic foods
• Avoiding tobacco and alcohol
• Using a mouthwash that doesn’t contain alcohol

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

These things can help mitigate factors that play a role in primary and secondary BMS.

Outlook

If you have BMS, it’s important to know that it is benign. It can be distressing and reduce your quality of life, but it isn’t life-threatening.

Furthermore, although BMS is uncommon and not fully understood, the symptoms can be managed. Try to get in touch with a specialist who knows about BMS.