Burning Mouth Syndrome

Overview

Burning mouth syndrome (BMS) is a painful condition often described as a burning, scalding, or tingling feeling in the mouth that occurs frequently, often every day, for months or longer. Some people feel constant pain every day. For others, pain is relatively low after waking but increases throughout the day.

While the burning sensation may occur anywhere in the mouth, it is more common on the tip, sides, and top of the tongue; roof of the mouth; and in the lips. Dry mouth or an altered taste in the mouth may accompany the pain.

BMS can be difficult to diagnose, partly because the burning sensation can occur even when the mouth looks healthy and blood tests are normal. Your dentist or doctor will rule out other conditions before diagnosing BMS.

Working closely with a dentist or doctor you trust and sharing your concerns can help during the process of getting a diagnosis.

Causes

Experts believe that BMS is caused by damage to the nerves in the mouth that control pain and taste. This condition is more common in women, especially after menopause. Sometimes, other oral or medical conditions can cause a burning sensation in the mouth. These conditions include:

Dry mouth, which can be caused by certain medicines, disorders (such as Sjögren’s disease), or treatments (such as radiation therapy)
Infection in the mouth, such as a yeast infection
Oral habits, such as tongue hyperactivity (increased tongue movements)
Allergies to dental products, dental materials (usually metals), or foods
Anxiety, depression, and stress
Acid reflux
Hormonal changes, such as those from diabetes or thyroid problems
Certain medicines, such as those that reduce blood pressure
Nutritional deficiencies, such as a low level of vitamin B or iron

Symptoms

The main symptom of BMS is pain in the mouth that feels like burning, scalding, or tingling. Or, the pain may happen with a feeling of numbness, which comes and goes. Other symptoms can include dry mouth or altered taste, such as a metallic taste, in the mouth. The pain usually occurs on the tongue but can also occur in the lips, the roof of the mouth, or throughout the mouth.

BMS pain can last for months or years. Some people feel constant pain every day. For others, pain is relatively low after waking but increases throughout the day. For many people, the pain is temporarily reduced when eating or drinking.

Diagnosis

People with BMS often have no visible signs in their mouth during an exam, so it may take time to diagnose.

Talk to your dentist first. Your dentist may refer you to a specialist in oral surgery, oral medicine, or oral pathology, or to an ear, nose, and throat specialist who can assist with diagnosing or treating BMS.

To diagnose BMS, a dentist or doctor will review your medical history and examine your mouth to rule out other conditions that may cause mouth pain, such as tooth and gum problems, infections, or irritation. Additional tests may be needed, such as:

Blood tests to check for certain medical problems
Oral swab tests
Allergy tests
Salivary flow tests
Imaging tests

Treatment

Because BMS is a complex condition, the treatment that works for one person may not work for another. You may need to try different treatments over time to manage your symptoms.

Your dentist or doctor may prescribe medicines that can help control pain and relieve dry mouth. Some medicines that are used to treat anxiety, depression, and other neurologic disorders can help reduce the discomfort caused by BMS. These medicines work by calming overactive nerves.

If your pain is due to an underlying oral or medical condition, treating that condition may help your symptoms go away. If a medicine is primarily causing the problem, your doctor may switch you to a different medicine.

Your dentist may also help you manage oral habits, such as tongue hyperactivity, that may contribute to BMS.

Helpful Tips

For many people, the pain is temporarily reduced when eating or drinking. To help ease the pain, sip a cold beverage, suck on ice chips, or chew sugarless gum.

Avoid things that can irritate your mouth, such as: