Information and Care – Burning Mouth Syndrome

DEFINITION

Burning Mouth Syndrome (BMS) is a persistent and painful condition characterized by a sensation of burning in various parts of the mouth, including the tongue, lips, palate, gums, inner cheeks, and the back of the mouth or throat. This discomfort cannot be easily linked to any physical abnormalities in the mouth or underlying medical issues.

This condition, which is complex and not fully understood, appears to affect women seven times more frequently than men. While most individuals experiencing Burning Mouth Syndrome are middle aged, younger people can also be affected.

Burning Mouth Syndrome may also be referred to by other names such as Burning Tongue Syndrome, Burning Lips Syndrome, Glossodynia, Stomatodynia, and Scalded Mouth Syndrome.

SYMPTOMS

Burning Mouth Syndrome is characterized by various symptoms, with the primary one being a sensation of pain or burning. This sensation is usually mild in the mornings, intensifying throughout the day and reaching its peak in the evening before subsiding at night. Some individuals with Burning Mouth Syndrome experience continuous pain, while others have intermittent burning sensations. The associated pain can persist for several months or even years.

Additional symptoms commonly reported in individuals with Burning Mouth Syndrome include dry lips, a sore or dry mouth, tingling or numbness at the tongue’s tip or in the mouth, and changes in taste, such as a bitter or metallic flavor.

CAUSES

The precise cause of Burning Mouth Syndrome remains unclear. A burning sensation in the mouth can be a symptom of various oral and systemic conditions. These conditions must be ruled out before diagnosing “burning mouth syndrome.”

Factors contributing to oral burning may include:

  • Nutritional Deficiencies: Lack of iron, folate, and vitamin B complex has been linked to a burning sensation in the mouth. Treatment approaches may involve supplements of B vitamins, zinc, and iron.
  • Dry Mouth (Xerostomia): Medications, Sjogren’s syndrome, and other causes can lead to dry mouth and the associated burning sensation. Managing dry mouth through liquid intake, artificial saliva, or addressing the root cause can reduce or eliminate the burning sensation.
  • Oral Candidiasis (Oral Thrush): This fungal infection can cause a burning sensation, especially when consuming certain foods. Treatment recommended by a dentist can alleviate the burning sensations associated with oral thrush.
  • Diabetes: Diabetics are more prone to oral infections, including oral thrush, leading to burning mouth sensations. Better control of blood sugar levels may prevent or improve burning mouth symptoms.
  • Menopause: Hormonal changes in middle-aged women have been linked to a burning sensation in the mouth. While hormone replacement therapy may help some patients, it is not universally effective.
  • Anxiety/Depression: Psychological issues do not directly cause burning mouth but may worsen symptoms. Anxiety or depression may lead to habits like tooth grinding or tongue thrusting, aggravating burning lips and mouth. Stress can also impact saliva flow, worsening oral burning.
  • Other Causes: Physical irritation from dentures, allergies to denture components or oral hygiene products, gastroesophageal reflux disease, low thyroid hormone levels, certain medications, changes in salivary composition, and cancer therapy are additional factors that could contribute to burning mouth symptoms.

TREATMENT

The goal of treating Burning Mouth Syndrome is to alleviate symptoms, employing medications commonly used for conditions like depression and chronic pain. Tricyclic antidepressants (e.g., amitriptyline/Elavil), antipsychotics (e.g., chlordiazepoxide/Librium), anticonvulsants (e.g., gabapentin/Neurontin), analgesics, benzodiazepines (e.g., clonazepam/Klonopin), and mucosal protectors have proven effective for some patients.

Over-the-counter alpha-lipoic acid supplements (600mg per day for 30 days) and topical capsaicin (found in cayenne pepper) have also shown promise in reducing Burning Mouth Syndrome symptoms. Alpha-lipoic acid is available in drug stores, supermarkets, and health food stores.

Despite success in certain cases, there is no universal treatment for Burning Mouth Syndrome. Each patient’s treatment is tailored to their specific needs. Treatment costs vary based on prescribed medications, duration, and insurance coverage.

Simple changes may provide additional relief:

  • Avoid alcohol-containing mouthwash.
  • Use toothpaste without sodium lauryl sulfate.
  • Chew sugarless gum (preferably with xylitol).
  • Avoid alcoholic beverages.
  • Brush teeth with baking soda and water.
  • Steer clear of highly acidic drinks (fruit juices, coffee, soft drinks).
  • Quit tobacco use.
  • Sip water or suck on ice chips.