- Burning mouth syndrome causes burning pain, tingling, dry mouth, and taste changes without visible signs in the mouth.
- It is more common after menopause but can also be linked to diabetes, hypothyroidism, allergies, medications, or nutritional deficiencies.
- Treatment depends on the cause and may include medication, dental adjustments, supplements, or managing triggers.
Burning mouth syndrome (BMS) is a condition that causes a persistent burning sensation in the mouth, affecting areas like the tongue, lips, cheeks, or roof of the mouth. It usually occurs without visible changes but can lead to symptoms such as pain, tingling, dry mouth, or changes in taste.
Burning mouth syndrome is more common in women between 40 and 60, especially during perimenopause or after menopause, but it can affect anyone. It may be linked to conditions such as diabetes, hypothyroidism, nutritional deficiencies, allergies, or the use of certain medications.
Treatment for burning mouth syndrome depends on the underlying cause and may include medications, dental adjustments, nutritional supplementation, or managing conditions like reflux or diabetes. Identifying triggers such as stress, spicy foods, or poorly fitted dentures can also help reduce symptoms and improve daily comfort.
Main symptoms
Burning mouth syndrome symptoms include:
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Burning or scalding feeling on the tongue, lips, inside of the cheeks, gums, palate (roof of the mouth), or throat
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Severe mouth pain
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Changes in taste, such as a metallic or bitter taste
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Dry mouth (xerostomia)
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Increased thirst
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Tingling or burning in the mouth or tongue
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Pain that gets worse throughout the day
Changes in saliva production
Symptoms can appear in any part of the mouth, but they are more common at the tip of the tongue and along the sides of the mouth.
According to the National Institute of Dental and Craniofacial Research, burning mouth syndrome symptoms can vary and may occur without visible changes in the mouth. In some cases, BMS pain starts during the day and gradually becomes more intense, which may even interfere with sleep.
Some factors can also worsen mouth burning, such as eating spicy or hot foods, stress, or tension.
Confirming a diagnosis
Burning mouth syndrome is diagnosed by an ENT specialist or dentist based on symptoms, a physical exam of the mouth, medical history, and current medication use.
The doctor may also order tests, such as a complete blood count, fasting blood sugar, iron, ferritin, and folic acid levels, saliva flow testing, MRI, or CT scan. These tests are used to rule out underlying conditions and help identify possible causes of burning mouth symptoms.
Other tests may include screening for autoimmune diseases and allergy testing for dental products or foods.
Possible causes
The causes of burning mouth syndrome are not fully understood. However, they can be classified into two main types based on their origin:
1. Primary or idiopathic burning mouth syndrome
In this type of BMS, symptoms are present, but no clear cause is identified. It is believed to happen due to damage to the nerves that help control taste and pain.
In this type of BMS, there is also no clinical or laboratory evidence that confirms the cause.
2. Secondary burning mouth syndrome
Secondary burning mouth syndrome is caused by an underlying health condition, such as:
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Allergy to foods or food preservatives, such as peanuts, tree nuts, cinnamon, or sorbic acid
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Allergy to dental products, such as amalgam, mercury, benzoyl peroxide, chlorhexidine, or zinc
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Hormonal changes, especially changes in estrogen during perimenopause or after menopause
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Nutritional deficiencies, especially iron or vitamin B12 deficiency
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Gastroesophageal reflux (GERD)
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Bruxism (teeth grinding)
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Infections caused by Enterobacter, Helicobacter pylori (H. pylori), or Klebsiella;
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Chronic mechanical trauma, such as poorly fitted dentures
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Oral candidiasis (yeast)
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Neuropsychiatric conditions, such as stress, chronic anxiety, or depression
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Uncontrolled diabetes mellitus
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Chemotherapy or radiation therapy to the head or neck area
In addition, the use of certain blood pressure medications, such as enalapril or captopril, antihistamines such as dexchlorpheniramine, or antipsychotic and anticonvulsant medications such as carbamazepine or phenytoin, may increase the risk of burning mouth syndrome.
Treatment options
Treatment for burning mouth syndrome should be guided by an ENT specialist or dentist, depending on the cause. Treatment may include adjusting dental prostheses, using a mouthguard for bruxism, dental laser therapy, or taking medication to treat infections, GERD, or diabetes.
When BMS is caused by allergies, it is important to identify the allergen and avoid contact with it. When the syndrome is caused by nutritional deficiencies, nutritional supplementation is usually recommended and should be taken as advised by a registered dietitian or doctor.
During flare-ups, when the pain is very intense, sucking on ice may help relieve pain. Ice can also help reduce dry mouth. It is also important to avoid situations that can trigger symptoms, such as tension, stress, talking too much, and eating very spicy foods.