Burning Mouth Syndrome: Symptoms, Causes & Treatment

Burning mouth syndrome is characterized by a burning sensation felt in any part of the mouth without any visible changes to oral tissue. This syndrome is most common in women between the ages of 40 and 60, but it can occur in anyone. 

With this syndrome, people often experience pain that worsens throughout the day, dry mouth, or a bitter or metallic taste in the mouth. It is important to see your doctor or dentist to evaluate your symptoms and identify a cause. Diagnosis is usually confirmed through assessment of the presenting symptoms, clinical history and test results. 

Treatment depends on the underlying cause, and is aimed at relieving symptoms. It may involve the use of medication or behavioral or lifestyle changes, like eating healthier, avoiding spicy food and taking time to relax. 

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Main symptoms

The symptoms of burning mouth syndrome can appear suddenly or gradually, The three most common symptoms are intense mouth pain, changes to taste (e.g. a metallic or bitter taste in the mouth), and dry mouth (aka xerostomia). These symptoms are referred to as the symptom triad of burning mouth syndrome. 

However, some people may also notice other symptoms like: 

  • Burning sensation on the tongue, lips, inside the cheeks, gums, palate or throat. 
  • Increased thirst
  • Tingling or burning tongue 
  • Loss if appetite 
  • Pain that increases throughout the day 
  • Changes to the amount of saliva produced

Symptoms can appear in any part of the mouth. They usually start on the tip of the tongue and the sides of the mouth. In some cases, pain from burning mouth syndrome emerges during the day and has a progressive intensity. It can even interfere with sleep. Some things can worsen the burning sensation, like eating spicy or hot food and stress. 

Possible causes 

The causes of burning mouth syndrome are still not completely known, however this condition can be categorized into two type: primary or secondary burning mouth syndrome. 

  1. Primary (or idiopathic) burning mouth syndrome: With this type, the symptoms are felt however the doctor is unable to identify an underlying cause through assessment or testing.  
  2. Secondary burning mouth syndrome: A cause is identifiable with this type. The condition may be related to allergies, infection, nutritional deficiencies, reflux, ill-fitting dentures, anxiety and depression, medication use, diabetes, Sjögren syndrome, or changes to nerves that control taste and pain. 

The diagnosis for burning mouth syndrome should be confirmed by a doctor depending on the symptoms reported by the patient, the clinical history and lab testing. Blood tests the doctor may order include a complete blood count, fasting sugar, iron level, ferritin and folic acid. The doctor will usually investigate for nutritional deficiencies, infection or chronic disease that could be causing burning mouth syndrome. 

In addition, the doctor may also order tests to investigate for auto-immune disease and allergy testing. 

Treatment options

Treatment for burning mouth syndrome depends on the underlying cause. You may be advised to refit your denture, undergo therapy (if related to a psychological issue), or take prescription medication (if related to reflux or an infection).

For burning mouth syndrome that is caused by allergies, it is important to identify the trigger and avoid contact with it. If this condition is caused by a nutritional deficiency, you should take supplements as advised by your doctor or registered dietitian. 

When pain is very intense, you may find relief by sucking on ice, which will help to cool and moisten the mouth. You should also avoid things that can trigger symptoms, like stress, talking too much or eating very spicy food.