Have you been experiencing a burning sensation in your mouth, but with no scalding to show for it? For many years, people who suffer from burning mouth syndrome have perplexed physicians and researchers. It is common for patients with this condition to have visited multiple doctors from different fields without getting any help. Fortunately, over time, the medical profession have learned more about the burning mouth syndrome, and although there is still no cure, there are several medications and treatments that can provide the needed relief.
What is it?
Burning Mouth Syndrome, also known as BMS, is a painful and frustrating condition that most patients compare to having burnt your mouth with hot coffee. The burning sensation may be felt on the tongue, gums, roof of the mouth, the inside of your cheeks, and sometimes, at the throat or back of the mouth.
The symptoms of BMS may include;
- A dry mouth
- A sore mouth
- Taste changes that feel bitter or metallic
- A sensation of numbness and tingling throughout your mouth and tongue
Although BMS is uncommon, you have a higher chance of getting it if;
- You are a woman
- You are post-menopausal
- You are aged over 50 years
Your doctor or dentist will start by reviewing your medical history. They will then examine your mouth and ask you to describe your symptoms, oral habits, and your oral care routine. They may also perform additional general medical examinations to look for signs of any other associated conditions. Some of these tests may include;
Complete blood cell count
This test may reveal various maladies, including infections and anaemia, which may be an indication of nutritional deficiencies.
Other blood tests
Your doctor may collect blood samples to check your blood levels for iron, folate, zinc, thiamin, pyridoxine, riboflavin and cobalamin. Also, since diabetes causes a burning mouth sensation, your doctor may check your blood sugar level.
This test will help determine if you are allergic to certain foods, additives or substances in your dentures.
Used to check for oral thrush. Since burning mouth syndrome is associated with a wide variety of other medical conditions, your doctor may refer you to a specialist for screening and diagnosis and even possible treatment.
There is no known or proven way to prevent BMS. However, avoiding smoking, acidic or spicy foods, carbonated beverages, and excessive stress can help reduce the discomfort or even prevent the condition from getting worse.
There are two types of BMS, which are differentiated by the cause;
This is when there is no identifiable cause of the condition. For an accurate diagnosis, your doctor may run several tests to check for any abnormalities. If an underlying condition is not found, your doctor may make a diagnosis of primary BMS.
Secondary BMS, on the other hand, has a clear, identifiable cause which may vary from one person to the other. Some of the possible causes of secondary BMS include;
Dry mouth (xerostomia)
Dry mouth may be attributed to the use of various medications like tricyclic antidepressant, lithium, diuretics, and high blood pressure medication. Dry mouth may also occur with ageing or as a result of Sjogren’s syndrome.
Lacking nutrients like iron, zinc, thiamin (vitamin B-1), folate (Vitamin B-12), riboflavin (vitamin B-2), cobalamin (vitamin B-12) and pyridoxine (vitamin B-6) might distress your oral tissues, causing the condition. These deficiencies can also cause anaemia.
Some dental dentures may exert stress on various tissues and muscles in your mouth causing burning mouth syndrome.
Allergies and reactions
Reactions and allergies to foods, food additives, food flavourings, dyes, fragrances and other substances may cause burning in your mouth.
Stomach acid reflux
Sometimes, the bitter or sour tasting fluid that goes into your mouth from the upper GI tract may cause a burning mouth.
Some medication used to control high blood pressure like Angiotensin-converting enzyme (ACE) inhibitors may cause a burning mouth syndrome.
Subconscious oral habits like teeth grinding (bruxism) and tongue thrusting may cause a burning mouth.
Sometimes, your oral tissues may act in response to high blood sugar levels, which often occur with conditions like diabetes and hypothyroid.
Excessive mouth irritation
Overuse of mouthwashes, consuming excessive acidic drinks or brushing your tongue excessively may cause a burning mouth.
Anxiety, depression and an extreme fear of cancer may also cause burning mouth syndrome.
Other oral conditions
There are other conditions like the oral yeast infection that may cause a burning mouth. This condition may be as a result of denture use, certain medications, or diabetes. Geographic tongue is a condition that causes a dry, sore mouth, patchy tongue which may also cause a burning mouth syndrome.
The complications caused by BMS include
- Difficulty sleeping
- Difficulty eating
Getting treatment for the burning mouth syndrome helps to minimize the symptoms. However, the type of treatment you receive will depend on the cause of your condition.
Primary BMS treatment
If you do not have any underlying problem that may be causing the burning mouth, the BMS resolves on its own over time. In the meantime, here are a few remedies to ease the symptoms;
- Suck on small ice chips or sip cold liquids to alleviate your symptoms
- Avoid acidic foods
- Change your toothpaste
- Avoid any food or drink that worsens your symptoms
- Practice relaxation techniques like meditation, yoga, and exercises to reduce stress
Secondary BMS treatment
Your doctor will prescribe medication to help relieve the burning mouth symptoms. They may also give you drugs that help promote the flow of saliva or ask you to drink more fluids.
Your health professional may prescribe an antidepressant or psychiatric therapy, or both.
Other oral conditions
For oral thrush, your doctor may prescribe antifungal medication such as thrush with miconazole or nystatin.
Readjusting your dentures may reduce the irritation in your mouth. You might need to have the dentures changed if they contain substances that irritate your oral tissues. Practising good denture care like removing them before sleeping and cleaning them well can also ease your symptoms.
Your doctor may prescribe supplements of B vitamins and minerals such as iron and zinc.
Avoiding foods or substances that have allergens that irritate your oral tissues may help.
Nerve issues or damage
Your doctor may prescribe medication that affects your nervous system to control the pain. They may also suggest rinsing your mouth with water and capsaicin to relieve the pain.
If your burning mouth is as a result of hypothyroidism or diabetes, treating these illnesses might improve your symptoms.
Mouth guards, relaxation techniques, and medication may help ease your burning mouth by preventing you from practising these oral habits.
Using substitute medication can help reduce your burning mouth.
When to see a doctor
You should see a doctor if you are experiencing persistent pain in your lips, tongue, gums or any other areas of your mouth. Your doctor is best placed to search for the possible cause or causes and will prescribe the best treatment. they will review your medical examination and examine your mouth. They may also condition multiple tests to determine the actual cause of your condition.
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Savina Clinic – Dental & Implantology Centres are friendly, state-of-the-art practices in Malta and Gozo dedicated to comprehensive quality dental care. Savina Dental is an innovative dental practice in Malta and prides itself on the high-quality customer service, low waiting room times, attention to detail and the advanced dental technology at their disposal.
Dr Joseph Xuereb
Dental & Implant Surgeon. Principal
Savina Dental Clinics