A woman making an uncomfortable face and holding her mouth.

Have a Strange Feeling in Your Mouth? It May Be Burning Mouth Syndrome

What is Burning Mouth Syndrome?

Burning mouth syndrome is a medical condition with several symptoms, including moderate to severe burning pain in the mouth, usually without accompanying clinical and laboratory findings. This uncommon medical condition is constantly being studied.

Due to the infrequent nature of this condition, causes of burning mouth syndrome remain unknown. However, several research studies show probable links to multiple possibilities of why a person develops this condition.

Pain Characteristics

The symptoms of burning mouth syndrome can occur suddenly or gradually over time. The pain can appear suddenly with no obvious cause. Once the pain starts, it usually persists for many years.

Although patients who have this condition may face different symptoms, the common characteristics that patients experience with this condition are:

  • Moderate to severe burning pain of the mouth, frequently involving the tongue, roof of the mouth, inside the cheeks, or the lining of the lower lip.
  • Accompanying the pain is changes in taste, such as a constant metallic, bitter taste. Some may experience an alteration of taste intensity, such as minimized or even loss of taste.
  • The sensation of dry mouth
  • Tingling or stinging sensations in the mouth in addition to the burning.
  • In some individuals, the pain is absent during the night. For others, it may progress throughout the day. The pain may be mild to moderate from late morning to severe in the afternoon to early evening. Difficulty falling asleep may occur because of the pain experienced at night time.

Fortunately, burning mouth syndrome does not affect the structure of the mouth or face. Symptoms, especially the burning sensation and changes in taste, are often reduced by eating or drinking.

Risk Factors

Burning mouth syndrome seems to be more common in women nearing menopause and more prevalent in post-menopausal women.

Although it starts without warning, some factors may increase your risks of developing it, such as a recent dental procedure, a preceding illness, or significant stress and anxiety.

Possible Burning Mouth Syndrome Causes

Because burning mouth syndrome is so uncommon, the leading cause remains unknown. This condition may stand by itself (Primary) or sometimes be associated or caused by another medical diagnosis or medical factor (Secondary).

Idiopathic Burning Mouth Syndrome (Primary) is when the symptoms of this condition cannot be attributed to other conditions. Laboratory test results are normal, and no other medical condition can be observed in the patient. It’s possible this may have resulted from an injury to the nerves in the tongue.

Certain medical conditions, drugs, or nutritional and hormonal imbalances may cause the symptoms of burning mouth syndrome. The syndrome can be linked to the following:

  • Increased blood sugar levels or even diabetes
  • Pain elsewhere in the body, such as recurrent headaches
  • Psychological factors such as personality and mood disorders, especially anxiety, stress, and depression
  • Nutritional deficiencies, particularly vitamins B1, B2, B6, B9, B12, zinc, and iron
  • Hormonal changes, which are especially found in post-menopausal women, and may also be found in those who have thyroid hormone imbalances (i.e., hypothyroidism)
  • Conditions causing dry mouth (i.e., Xerostomia)
  • Medications such as angiotensin-converting enzyme (ACE) inhibitors used for treating hypertension
  • Oral thrush, which is a form of fungal infection in the oral cavity caused by the Candida species
  • Acid reflux, which is primarily seen in patients who have gastroesophageal reflux disease (GERD)
  • Poor oral hygiene practices such as excessive use of strong mouthwash, excessive intake of acidic beverages, aggressive brushing of the tongue, or use of irritating toothpaste

Symptom Management

Since burning mouth syndrome cannot be attributed to a single cause, treatment aims to control factors that may have accompanied the syndrome. The first step is to see your doctor, who will investigate if primary or secondary factors cause your condition.

Treatment of primary burning mouth syndrome is directed at its symptoms. Your doctor may prescribe medications, such as benzodiazepines (i.e., Clonazepam), tricyclic antidepressants (i.e., Amitriptyline), anticonvulsants (i.e., Gabapentin), or topical capsaicin.

Secondary burning mouth syndrome is generally treated by addressing the underlying condition, stopping or changing medication, or fixing the nutritional or hormonal imbalances.

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