Burning Mouth Syndrome

Burning mouth syndrome (BMS) causes mouth pain that causes burning, tingling or scalding sensations. The syndrome can affect any part of your mouth and throat, but it typically causes pain in your tongue, the roof of your mouth or your lips. You may have a bitter or metallic taste in your mouth.

This condition is rare. The American Academy of Oral Medicine estimates it affects about 2 out of 100 people in the U.S. It’s more common in women.

Treatment will vary. For example, a medical condition may make your mouth burn. In that case, treating it may cure burning mouth syndrome or make your symptoms less noticeable. But in some cases, there’s no obvious cause and no cure. But, again, some treatments can make the burning sensation less noticeable.

Types of burning mouth syndrome

There are two types of this condition:

• Primary BMS is when your mouth feels like it’s burning, but there’s no clear reason why.
• Secondary BMS is when another issue makes your mouth burn. Treating the issue may make your BMS symptoms go away.

Symptoms of burning mouth syndrome

This condition causes painful burning, scalding or tingling sensations in different parts of our mouth. Other symptoms are:

• Altered taste
• Dry mouth
• Numbness in your mouth that comes and goes

You may have symptoms at different times of the day or night. For example, you may:

• Feel fine when you first wake up, but then have symptoms that get worse throughout the day
• Start the day with symptoms that don’t get better or worse, but never go away
• Have symptoms that don’t happen every day

BMS causes and risk factors

Nerve damage that affects the parts of your tongue that control taste and pain may cause primary burning mouth syndrome. Researchers continue to look for specific issues that may cause nerve damage in your mouth. Some research indicates factors like stress or hormonal changes may trigger this type of the condition.

There are clearer causes for secondary BMS, including certain underlying medical conditions or medications. Medical conditions that can cause or increase your risk for secondary BMS include:

• Allergic reactions: Dental treatment materials may cause an immune system response that leads to BMS. An allergic reaction to certain foods may make your mouth burn.
• Diabetes: This disease may cause nerve damage in your mouth, increasing your risk of burning mouth syndrome.
• Geographic tongue: This disease may lead to BMS.
• GERD (acid reflux): Stomach acid that backs up into your mouth can damage nerve endings, so you have BMS symptoms.
• Dry mouth: Lack of saliva (spit) may irritate nerve endings.
• Menopause: Changes to estrogen levels during menopause can affect your mouth, so it’s more sensitive to irritation.
• Mental health issues: Issues like chronic anxiety or depression may increase your risk.
• Oral infections: Bacterial infections or viral infections like oral thrush cause inflammation that damages nerve endings in your mouth.
• Stress: Research shows a connection between stress and secondary BMS. Stress may make you grind your teeth and cause inflammation.
• Vitamin deficiencies: This can happen if you don’t get enough vitamin B 12, vitamin D, folate, iron and zinc from the food you eat.

Complications of burning mouth syndrome

This condition can affect your quality of life. The burning sensation and pain can make eating and drinking difficult. The sensation can keep you awake at night and make you feel anxious and stressed during the day. Some people develop mental health issues, like depression.

If you have symptoms, see a dentist first. They’ll look at your mouth and tongue. While burning mouth syndrome doesn’t cause obvious symptoms like a bump, your dentist may check for issues like grinding your teeth that can cause secondary BMS.

Your dentist may refer you to specialists for tests to check for underlying conditions. You may have:

• Allergy tests
• Blood tests
• Imaging tests, like dental X-rays, CT scans or MRI
• Oral swab test
• Saliva test
• Tissue biopsy

How is burning mouth syndrome treated?

Treatment may help with symptoms, but there’s no cure. Your treatment will depend on whether you have primary or secondary BMS. For example, if vitamin deficiencies cause secondary BMS, taking supplements may help. If grinding your teeth causes it, your dentist can make a custom mouth guard. The mouth guard protects your teeth and reduces inflammation in your mouth.

If you have primary BMS, there are treatments that can help manage pain and make the burning sensation less noticeable. Your provider may prescribe:

• Mouth rinses with mild numbing effects
• Pain relievers, like acetaminophen (Tylenol®) or ibuprofen (Advil®)
• Saliva substitutes, like Biotene®

They may recommend support and medication to help you manage the mental health issues that living with this condition may cause. Some possible treatments include:

• Antianxiety medications like clonazepam (Ceberclon® or Klonopin®) that help calm your nervous system
• Antidepressants like nortriptyline (Aventyl® and Pamelor®) that help regulate your mood
• Cognitive behavioral therapy to help you manage the impact of anxiety or chronic pain, which primary BMS may cause

How can I get relief from burning mouth syndrome?

Burning mouth syndrome treatments may take time to be effective. If you have primary BMS, you and your healthcare provider may need to try different treatments to find the ones that work best. In the meantime, try:

• Sipping cold beverages and sucking on ice chips
• Chewing sugar-free gum to help your salivary glands make more saliva to keep your mouth moist

And it’s a good idea to avoid things that may irritate your mouth and boost the burning sensation in your mouth. Examples include:

• Beverages with alcohol
• Extremely hot foods or beverages
• High-acidic foods or drinks (like citrus juices)
• Hot and spicy foods or drinks
• Mouthwash with alcohol
• Smoking or vaping

Recovery time

Without treatment, burning mouth syndrome can last for months or even years. That can be a long time to live with mouth pain. BMS treatment can provide relief within days or weeks. Talk to your healthcare provider about your specific treatment and when you can expect to feel better.

When should I see my healthcare provider?

You should contact a provider if there’s a burning sensation in your mouth that:

• Happens for no apparent reason
• Lasts longer than a few days
• Gets worse
• Causes other symptoms, like swelling or blisters

What can I expect if I have this condition?

There’s no cure for primary burning mouth syndrome. But there are treatments and other ways to manage your symptoms. The situation is different for BMS that happens when you have issues like GERD or an oral infection. Treating the underlying condition may cure it.