What is it?
Burning mouth syndrome is the medical term for ongoing (chronic) or recurrent burning sensation in the mouth that has no obvious cause. Discomfort may affect the tongue, gums, lips, inside of the cheeks, and/or roof of the mouth. The sensation, which can be severe like a scald, can be limited to a small area or spread through the whole mouth.
Burning mouth syndrome either appears suddenly or may develop gradually over time and, unfortunately, the cause remains uncertain which makes treatment more challenging. However, often the symptoms can be helped by working closely with a health care team.
Typically, your GP/physician and dentist may order allergy tests, take swabs or biopsy of the tissues. MRIs, CT scans or blood tests can also assist in the diagnosis. In addition, ENT specialists, as well as dermatologists and gastroenterologists may be consulted to assist in the search for causative or aggravating factors.
Primary burning mouth syndrome
When no clinical or lab abnormalities are identified, the condition is called primary or idiopathic burning mouth syndrome. Some research suggests this could be related to problems with taste and the sensory nerves of the peripheral or central nervous system.
Secondary burning mouth syndrome
Sometimes burning mouth syndrome is related to an underlying medical condition and is then known as secondary burning mouth syndrome.
Underlying problems may include:
• Dry mouth (xerostomia), which can be caused by various medications, health problems, problems with salivary gland function or the side effects of cancer treatment
• Other oral conditions, such as a fungal infection of the mouth (oral thrush), an inflammatory condition called oral lichen planus or a condition called geographic tongue that gives the tongue a map-like appearance
• Nutritional deficiencies, such as a lack of iron, zinc, folate (vitamin B-9), thiamine (vitamin B-1), riboflavin (vitamin B-2), pyridoxine (vitamin B-6) and cobalamin (vitamin B-12)
• Dentures, especially if they don’t fit well, can place stress on muscles and tissues of your mouth. Or they could contain materials that irritate the tissues.
• Allergies or reactions to foods, food flavouring, other food additives, fragrances, dyes or dental-work substances
• Reflux of stomach acid that enters your mouth (gastroesophageal reflux disease or GERD)
• Certain medications, particularly high blood pressure medications
• Oral habits, such as tongue thrusting, biting the tip of the tongue and teeth grinding (bruxism)
• Endocrine disorders, such as diabetes or underactive thyroid (hypothyroidism)
• Excessive mouth irritation, which may result from overbrushing your tongue, using abrasive toothpastes, overusing mouthwashes or having too many acidic drinks
• Psychological factors, such as anxiety, depression or stress
Another classification of burning mouth syndrome is based on symptoms as follows:
• Type 1: There are no symptoms upon waking, with progression throughout the day with variable symptoms at night. Nutritional deficiency and diabetes may produce a similar pattern.
• Type 2 Symptoms that are continuous throughout the day and frequently symptom-free at night. This type is associated with chronic anxiety.
• Type 3: Intermittent symptoms throughout the day with symptom-free days. Food allergy is suggested as a potential mechanism.
Symptomatic relief of burning mouth syndrome
When a cause or aggravating factors, and therefore a clear plan of treatment, can not be identified, the focus turns to symptom relief. There are a variety of natural as well as prescribed remedies.