What are the symptoms of burning mouth syndrome?

Burning mouth syndrome (BMS) is a condition characterized by a burning sensation in the mouth. The main symptoms include:

1. Burning pain or scalding sensation in the mouth
   This is the primary symptom and can affect the tongue, lips, gums, palate, throat or whole mouth. The burning feeling can be constant or come and go.
2. Dry mouth or increased thirst
   Many people with BMS experience dry mouth or a feeling of mouth dryness along with the burning sensation.
3. Altered taste or loss of taste (dysgeusia)
   A bitter, metallic or otherwise unpleasant taste is commonly reported by BMS patients.
4. Tingling or numb sensation in the mouth
   In addition to burning, some patients describe tingling, stinging or numb areas in their mouth.
5. Pain when eating certain foods
   Acidic, salty, hot or spicy foods can exacerbate the burning sensation for some.
6. Oral soreness or mouth pain
   The mouth can feel generally sore as well as experiencing a distinct burning feeling.

The symptoms tend to be better in the morning and worsen through the day. Burning mouth syndrome often occurs without any visible mouth lesions or causes. The symptoms can last for years with periods of remission and recurrence.

Additional signs that may accompany BMS include dry lips, increased thirst, anxiety, taste changes, and difficulty swallowing or eating. Seeking medical evaluation is important to rule out underlying causes.

What are the causes of burning mouth syndrome?

There is no single known cause of burning mouth syndrome (BMS), but several potential factors have been identified:

1. Neuropathic pain – Some cases may be caused by damage or dysfunction of the nerves that control pain and taste sensations in the mouth.
2. Hormonal changes – BMS is more common in women, especially after menopause, suggesting hormonal imbalances may play a role.
3. Dry mouth – Decreased saliva production can allow irritating substances to accumulate, leading to oral burning sensations.
4. Nutritional deficiencies – Deficiencies in vitamins like vitamin B1, vitamin B2, vitamin B6, vitamin B12, zinc, and iron have been linked to some cases of BMS.
5. Oral candidiasis – Overgrowth of Candida fungus in the mouth can sometimes trigger BMS symptoms.
6. Acid reflux – Acid from the stomach entering the mouth and throat may contribute to burning sensations.
7. Poorly fitting dentures – Dentures that don’t fit properly can irritate the mouth tissues.
8. Oral habits – Tongue thrusting, teeth grinding, and other oral habits may precipitate BMS in some people.
9. Medications – Certain medications like those for high blood pressure have been associated with BMS as a side effect.
10. Psychological factors – Anxiety, depression, and stress may play a role in some BMS cases.

In many instances, the exact underlying cause remains idiopathic or unknown. Managing any identifiable triggers and treating associated conditions may help reduce BMS symptoms.

How is burning mouth syndrome treated?

Burning mouth syndrome (BMS) can be difficult to treat, but there are several potential treatment approaches:

1. Treat underlying causes
   If an underlying condition like dry mouth, nutritional deficiency, oral candidiasis, or ill-fitting dentures is identified as contributing to BMS, treating that condition may help relieve symptoms.
2. Oral rinses/lubricants
   Using saliva substitutes or mouth rinses containing lidocaine, antihistamines, or anti-inflammatory agents can provide symptomatic relief.
3. Topical medications
   Prescription mouth gels/ointments containing capsaicin, clonazepam, or other neuropathic pain relievers may be helpful.
4. Oral medications
   Certain medications like alpha-lipoic acid, gabapentin, low-dose antidepressants (amitriptyline), and benzodiazepines have been used to manage neuropathic pain in BMS.
5. Hormone replacement therapy
   For post-menopausal women, hormone replacement may restore hormonal balance and relieve BMS symptoms.
6. Vitamin/mineral supplements
   Supplements like alpha-lipoic acid, vitamin B12, vitamin D, zinc, and iron are sometimes recommended if deficiencies are detected.
7. Cognitive behavioral therapy
   Managing stress and anxiety through CBT and other psychological therapies may provide relief for some BMS patients.
8. Diet changes
   Avoiding acidic, salty, and spicy foods and maintaining good oral hygiene can help minimize symptom flare-ups.
9. Low-level laser therapy (LLLT)
   Some studies suggest LLLT applied to the mouth and tongue may be beneficial.

A combination of different therapies targeting potential causes by your healthcare provider is often needed, as there is no single cure. Regular follow-ups are required to monitor symptom changes.