Burning Mouth Syndrome
Persistent burning sensation in the mouth with no obvious cause
Quick Facts
- Type: Chronic oral pain disorder
- Main symptom: Burning of tongue, lips, or palate
- More common in: Women after menopause
- Often linked to: Nerve changes, dry mouth, deficiencies
Overview
Burning mouth syndrome is an ongoing burning, scalding, or tingling sensation in the mouth that has no clear cause that a doctor can see during an examination. The tongue is most often affected, but the lips, gums, palate, and inside of the cheeks can also burn. The discomfort can be constant or come and go, and it may build through the day.
The condition is divided into two types. Primary burning mouth syndrome has no identifiable medical or dental cause and is thought to involve changes in the nerves that carry taste and pain signals. Secondary burning mouth syndrome is caused by an underlying problem such as dry mouth, a nutritional deficiency, or a yeast infection, and it often improves once that problem is treated.
Symptoms
The hallmark is a burning feeling, but several other sensations often go with it.
- Burning or scalding sensation, most often on the tip and sides of the tongue
- A feeling of dryness even when saliva is present
- Altered taste, such as a bitter or metallic flavor
- Loss of taste in some people
- Tingling, numbness, or a stinging feeling in the mouth
A telling feature is that the burning frequently eases while eating or drinking and is often absent during sleep, then returns and may worsen as the day goes on. The mouth usually looks completely normal, which can be frustrating for people seeking an explanation.
Causes
In primary burning mouth syndrome, the problem is believed to lie in the nerves that handle taste and pain in the mouth, which begin sending faulty signals. No tests confirm this directly, so it is diagnosed when other causes are ruled out.
Secondary burning mouth syndrome can result from many conditions, including:
- Dry mouth from medications, salivary gland problems, or autoimmune conditions
- Nutritional deficiencies such as low iron, zinc, folate, or B vitamins
- Oral yeast infection (thrush) or other infections
- Acid reflux reaching the mouth
- Allergic or irritant reactions to dental materials, toothpaste ingredients, or foods
- Hormonal changes, diabetes, or thyroid disorders
Risk Factors
- Being a woman, especially after menopause
- Older age
- Recent dental procedures or illness
- Anxiety, depression, or high stress
- Habit of clenching the jaw or pressing the tongue against the teeth
- Taking certain blood pressure medicines that can affect taste and saliva
Diagnosis
There is no single test for burning mouth syndrome, so diagnosis works by careful history and ruling out other causes. A doctor or dentist may:
- Examine the mouth for visible problems such as thrush, ulcers, or dryness
- Order blood tests to check for anemia, vitamin or mineral deficiencies, diabetes, and thyroid problems
- Take swabs or biopsies if infection or another oral disease is suspected
- Review medications that can cause dry mouth or taste changes
- Ask about reflux, allergies, and dental products used
When all of these are normal and the burning continues, primary burning mouth syndrome is the likely diagnosis.
Treatment
Treatment depends on the type. When an underlying cause is found, treating it often resolves the burning. For primary burning mouth syndrome, the goal is to calm the abnormal nerve signals and ease symptoms.
- Correcting causes: Treating thrush, replacing low vitamins or minerals, managing reflux, and adjusting medications that cause dry mouth.
- Saliva support: Sipping water, sugar-free gum or lozenges, and saliva substitutes for dryness.
- Nerve-targeted medicines: Low doses of certain medications used for nerve pain or mood can reduce burning, prescribed and monitored by a doctor.
- Topical treatments: Mouth rinses or gels that numb or soothe the tissue.
- Behavioral support: Stress reduction and cognitive behavioral therapy can help, since anxiety often worsens the sensation.
Relief can take time and may require trying more than one approach. The condition is not dangerous and does not lead to mouth cancer.
Self-Care
- Sip water often and avoid acidic, spicy, or very hot foods that worsen burning
- Limit alcohol, tobacco, and strongly flavored mouthwashes that can irritate
- Switch to a mild toothpaste without strong flavoring agents if these seem to trigger symptoms
- Manage stress through relaxation techniques, exercise, or counseling
- Keep up regular dental care to catch dryness or infection early
When to See a Doctor
See a doctor or dentist if you have an ongoing burning, scalding, or tingling feeling in your mouth that lasts more than a couple of weeks, especially if it affects eating, sleep, or mood. Seek evaluation sooner if you also notice white patches, ulcers that do not heal, a lump, unexplained bleeding, or numbness, as these point to other conditions that need their own assessment.
Frequently Asked Questions
What does burning mouth syndrome feel like?
It feels like the tongue, lips, or palate have been scalded by a hot drink, even though nothing has burned them. The sensation can be constant or come and go, and it often eases while eating and worsens as the day goes on.
Is burning mouth syndrome a sign of cancer?
No. Burning mouth syndrome is not cancer and does not turn into cancer. However, a non-healing sore, lump, or white or red patch should always be checked by a doctor or dentist to rule out other conditions.
What deficiencies cause burning mouth?
Low levels of iron, zinc, folate, and B vitamins can cause burning in the mouth. Blood tests can detect these, and correcting the deficiency often relieves the symptom in secondary burning mouth syndrome.
How long does burning mouth syndrome last?
When there is a treatable cause, it can resolve within weeks of treatment. Primary burning mouth syndrome can persist for months or years, though symptoms often improve with the right combination of treatments and self-care.
Can stress cause burning mouth syndrome?
Stress and anxiety do not cause the condition on their own, but they can intensify the burning and make it harder to cope with. Managing stress is often part of an effective treatment plan.
References
- Mayo Clinic. Burning mouth syndrome — Symptoms and causes.
- National Institute of Dental and Craniofacial Research (NIDCR). Burning Mouth Syndrome.
- MedlinePlus, U.S. National Library of Medicine. Burning mouth syndrome.
- American Academy of Oral Medicine. Burning Mouth Syndrome.