Burning Mouth: Symptoms, Causes & Treatment

Evidence Based
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What Is Burning Mouth Syndrome (BMS)?

Stomatodynia, commonly called burning mouth syndrome (BMS) or burning tongue syndrome, is a rare and complex oral condition that produces a burning, tingling, or scalding feeling in the mouth. 

The effects can be mild, moderate, or severe. BMS can affect the tongue, palate, and other areas in your mouth. The most common locations of pain are the tip of the tongue and the roof of the mouth. In most cases, the burning pain comes on suddenly and is not triggered by an apparent cause. 

BMS is difficult to diagnose. There are no visible signs that a doctor or dentist can see. They may refer you to a specialist in oral medicine or oral surgeon. They may also refer to you ear, nose, and throat specialists, dermatologists, allergists, rheumatologists, or gastroenterologists. 

Several tests may be performed to diagnose BMS, including:

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

There are two types of burning mouth, primary burning mouth syndrome, and secondary burning mouth syndrome. 


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Primary Burning Mouth Syndrome

This type of burning mouth is associated with taste problems and issues related to the central nervous system’s sensory nerves. Experts believe that this is caused by damage to the nerves that control taste and pain. Primary burning mouth syndrome is diagnosed when there is no underlying medical condition.

Secondary Burning Mouth Syndrome 

Unlike primary BMS, secondary BMS is usually caused by an underlying medical condition. Potential causes include:

Medication-Induced Dry Mouth

A mild oral condition when the salivary glands in the mouth do not generate enough saliva to keep your mouth wet. Medications taken for certain medical conditions, such as high blood pressure, can cause dry mouth and possibly burning mouth. Sjögren’s syndrome, chemotherapy, and radiation therapy are also associated with dry mouth.  

Oral Thrush

Oral thrush (oral candidiasis) is a yeast infection resulting from an overgrowth of Candida fungus that lives in the mucous membranes lining in the mouth. The most common sign of thrush is white patches (lesions) that develop on the tongue, cheeks, lips, or palate. You may also experience soreness and redness around the lesion or a burning sensation on the tongue or around the lesion. 

Nutritional Deficiencies

If you are deficient in certain vitamins, such as zinc, iron, folate, vitamin B1, vitamin B2, vitamin B6, and vitamin B12, you may develop BMS over time.

Other Causes

Other possible causes of burning mouth syndrome include:

  • Hormonal changes that occur during menopause or if you have thyroid disease
  • If you are allergic to certain dental materials, metals, or foods, you can develop BMS
  • Gastroesophageal reflux disease (GERD), also called acid reflux, which is when stomach acid irritates the esophagus
  • Diabetes and other metabolic disorders
  • Bruxism (excessive teeth grinding), clenching, and tongue thrusting. Teeth grinding and clenching are associated with anxiety, which can also initiate BMS
  • Oral inflammatory conditions including geographic tongue,  lichen planus, and yeast infections
  • Fungal infections

There are only about 20,000 cases of burning mouth syndrome in the U.S. each year. 

Symptoms of Burning Mouth Syndrome

Burning or scalding sensations in the mouth can lead to chronic pain. In addition, burning mouth syndrome is often accompanied by other conditions, including:

Dry Mouth

Dry mouth (xerostomia) reduces your quality of life and affects simple day-to-day activities. If you have dry mouth, it can worsen the mouth pain caused by BMS. Tasting, eating, speaking, and swallowing are also negatively impacted. Untreated dry mouth can also lead to the widespread production of cavities or dental erosion. 

Other burning mouth symptoms include:

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

Pain associated with BMS can last a long time. In addition, the pain may be constant or increase slowly throughout the day. Eating or drinking often reduces the pain for many people. 

Dentures do not cause BMS, but dentures, especially if they don’t fit well, can worsen the symptoms. 

Burning Mouth Syndrome Treatment

Your dentist and doctor will work with you to find a treatment that helps reduce your symptoms. For secondary BMS, treating the underlying cause will cure your BMS. For primary BMS, some treatment options include:

  • Medication (typically low-dosages of gabapentin, diazepam, nortriptyline, amitriptyline, or clonazepam)
  • Capsaicin
  • Holistic approaches that may include psychotherapy, exercise regimens, and mindfulness

If you are diagnosed with BMS, there are ways to reduce the pain. For example, dentists recommend drinking cold beverages and sucking on ice chips. Avoiding substances that may irritate your mouth cause can also reduce the symptoms of BMS, including:

  • Spicy foods
  • Acidic foods
  • Alcoholic or highly acidic drinks
  • Mouthrinses that contain alcohol
  • Citrus juices and fruits

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Resources

“Burning Mouth Syndrome.” Genetic and Rare Diseases Information Center, U.S. Department of Health and Human Services, https://rarediseases.info.nih.gov/diseases/5974/burning-mouth-syndrome.

“Burning Mouth Syndrome Causes, Symptoms, Diagnosis, Treatment.” National Institute of Dental and Craniofacial Research, U.S. Department of Health and Human Services, https://www.nidcr.nih.gov/health-info/burning-mouth/more-info#causes.

“Candida Infections of the Mouth, Throat, and Esophagus | Fungal Diseases | CDC.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, https://www.cdc.gov/fungal/diseases/candidiasis/thrush/index.html.

Tucker, Abigail S., and Isabelle Miletich. Salivary Glands: Development, Adaptations, and Disease. Karger, 2010.

Updated on: August 6, 2020
Author
Alyssa Hill
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Medically Reviewed: January 25, 2020
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Lara Coseo
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