Discover the causes, symptoms, and effective relief options for Burning Mouth Syndrome on Meri Sehat. Expert advice to manage the condition.

Burning Mouth Syndrome

Overview

Burning mouth syndrome (BMS) is characterized by a continuous burning sensation in the mouth, particularly on the tongue, as well as other oral symptoms such as a metallic taste and dry mouth<a href="#accordion">[1]</a>. 
&nbsp;

Burning mouth syndrome is a chronic pain condition, most commonly observed in postmenopausal women and middle-aged patients. It is characterized by a recurring burning sensation in the mouth, without any obvious cause, such as oral lesions.

The incidence and prevalence of burning mouth syndrome (BMS) vary depending on the population studied and the diagnostic criteria used. Research estimates an overall prevalence of 4%, with a 3-7 times greater risk in women than men7. Furthermore, an increased prevalence has been seen with advancement in age for e.g. Studies have shown a 1.92% prevalence in people under 50 years, compared to 3.31% in those older than 50 years<a href="#accordion">[7]</a>. 
&nbsp;

Burning mouth syndrome can be classified based on its cause and symptoms. Based on etiology, it can be divided into primary and secondary burning mouth syndrome. 
&nbsp;

<ol>
	<li>Primary BMS: This type of BMS has no identifiable underlying cause and is believed to be related to damage or dysfunction of the nerves that control pain and taste in the mouth. Primary BMS is often characterized by a burning sensation on the tongue, lips, and other parts of the mouth, along with a metallic or bitter taste and dry mouth. It is also called idiopathic burning mouth syndrome. 
	&nbsp;</li>
	<li>Secondary BMS: This type of BMS is associated with an underlying medical condition or medication use. Secondary BMS may be caused by conditions such as <a href="https://merisehat.pk/disease/diabetes-type-1-and-2">diabetes</a>, <a href="https://merisehat.pk/disease/hypothyroidism">hypothyroidism</a>, oral thrush, or acid reflux, or by medications such as those used to treat high blood pressure or depression. It is often characterized by a burning sensation that is more widespread and may also involve the throat and other areas of the body. 
	&nbsp;</li>
</ol>

Burning mouth syndrome can be classified into three types based on the symptoms<a href="#accordion">[2]</a> <a href="#accordion">[7]</a>.

<ul>
	<li>Type 1 - It affects approximately 35% of patients. The individual wakes up without pain but has progressive pain throughout the day. It may be associated with nutritional deficiencies and diabetes.</li>
	<li>Type 2 - This represents 55% of cases. The individual has continuous pain throughout the day and may find it difficult to sleep at night. Psychological disorders, such as chronic anxiety, can cause type 2 BMS.</li>
	<li>Type 3 - This is characterized by intermittent pain with symptom-free days. Food allergens can result in this type of BMS. 
	&nbsp;</li>
</ul>

Signs and Symptoms

Burning mouth syndrome (BMS) is a chronic condition characterized by a burning sensation in the mouth, often accompanied by a metallic or bitter taste, dryness, or soreness. Here are some signs and symptoms of BMS: 
&nbsp;

<ol>
	<li>Persistent burning sensation in the mouth, typically affecting the tongue, lips, and/or palate.</li>
	<li>Dry mouth (xerostomia) or an unusually increased salivary flow.</li>
	<li>Loss or alteration of taste (dysgeusia)</li>
	<li>Tingling or numbness in the mouth or on the tongue.</li>
	<li>A metallic, bitter, or sour taste in the mouth (metallic taste disorder).</li>
	<li>Sore mouth, tongue, or throat.</li>
	<li><a href="https://merisehat.pk/disease/anxiety">Anxiety</a>, <a href="https://merisehat.pk/disease/depression">depression</a>, or other mood disorders may also occur in some patients with BMS.</li>
</ol>

It&#39;s important to note that the symptoms of BMS can vary from person to person, and some people may experience only a few of these symptoms. 
&nbsp;

Note: If you are experiencing any of the above symptoms, it&#39;s important to consult your doctor or dentist for a proper diagnosis and treatment. 
&nbsp;

Causes

The exact mechanism of action of burning mouth syndrome (BMS) is not fully understood, but several factors have been suggested to play a role in its development. One theory proposes that BMS is caused by peripheral and/or central neuropathic changes, which can result in altered sensory processing and pain perception in the oral cavity. Other possible contributing factors include hormonal changes, psychological factors, oral infections, and nutritional deficiencies<a href="#accordion">[3]</a>.

The causes of burning mouth syndrome can be segregated on the basis of primary or secondary types<a href="#accordion">[6]</a>: 
&nbsp;

<h5>Primary BMS</h5>

The disease is known as primary or idiopathic burning mouth syndrome when no cause can be identified. According to some studies, primary burning mouth syndrome may be linked to issues with the nerves that control taste and pain. 
&nbsp;

<h5>Secondary BMS</h5>

There are instances when an underlying medical condition contributes to burning mouth syndrome. It is known as secondary burning tongue syndrome in these circumstances.

The following issues may be the cause of secondary burning tongue syndrome: 
&nbsp;

<ul>
	<li>Dry Mouth: This can be caused by certain medications, health problems, issues with the salivary glands, or as a side effect of cancer treatment.</li>
	<li>Other Oral Conditions: Conditions like oral thrush, oral lichen planus, or geographic tongue can result in burning mouth syndrome.</li>
	<li>Not Getting Enough Nutrients:&nbsp; Deficiency of cobalamin, folate (vitamin B-9), pyridoxine (vitamin B-6), riboflavin (vitamin B-2), copper, zinc, folate (Vitamin B-9), and thiamin (Vitamin B-1) and (Vitamin B-12) can result in secondary BMS.</li>
	<li>Allergies Or Reactions: Allergies to dental materials, mouth care items, food flavorings, other dietary additives, fragrances, or dyes are known to result in the condition.</li>
</ul>

<ul>
	<li>Reflux Of Stomach Acid: Also known as gastroesophageal reflux disease (GERD), it results in stomach acid entering the mouth.</li>
	<li>Specific Medicines: Particularly medications for high blood pressure.</li>
	<li>Oral Habits: Habits like biting the tip of the tongue, pressing the tongue against the teeth, and clenching or grinding the teeth can result in symptoms of BMS</li>
	<li>Endocrine disorders: These include diabetes or an underactive thyroid known as hypothyroidism.</li>
	<li>An Extremely Irritated Mouth: This may be brought on by using abrasive toothpastes, excessive mouthwash use, or consuming an excessive amount of acidic meals and beverages. Uncomfortable dentures may irritate the mouth, which can exacerbate symptoms.</li>
	<li>Psychological Issues: These include anxiety, depression, or stress. 
	&nbsp;</li>
</ul>

There is no definitive screening test for burning mouth syndrome (BMS). However, a thorough examination of the mouth and tongue may reveal signs of inflammation, oral infections, or other conditions that could be causing the symptoms. 
&nbsp;

Diagnosis

There is no specific diagnostic test for burning mouth syndrome and diagnosis is usually made based on a patient&#39;s symptoms and medical history. However, several tests may be done to rule out other conditions that could be causing the symptoms of BMS. This include<a href="#accordion">[6]</a>: 
&nbsp;

<ol>
	<li>Oral Examination: A visual examination of the mouth and tongue may reveal signs of inflammation, oral infections, or other conditions that could be causing the symptoms.</li>
	<li>Biopsy: A small sample of tissue may be removed from the affected area for microscopic examination to check for signs of infection or inflammation.</li>
	<li>Blood Tests: Blood tests may be done to check for nutritional deficiencies or other underlying medical conditions that could be contributing to BMS.</li>
	<li>Salivary Flow Rate Test: A test to measure the amount of saliva produced by the salivary glands. A reduced salivary flow is often seen in BMS.</li>
	<li>Allergy Testing: Allergy testing may be recommended if there is suspicion of a food or dental material allergy. 
	&nbsp;</li>
</ol>

Treatment

The treatment of burning mouth syndrome depends on the underlying cause, if one can be identified. If the cause is unknown or cannot be treated, then the focus is on managing the symptoms. Here are some common treatments for BMS<a href="#accordion">[5]</a>: 
&nbsp;

<ol>
	<li>Medications: Depending on the individual case, medications such as antidepressants, anticonvulsants, or benzodiazepines may be prescribed to help manage the pain and other symptoms associated with BMS.</li>
	<li>Topical Therapies: Topical therapies such as capsaicin or benzocaine can be applied directly to the affected area to help relieve pain.</li>
	<li>Saliva Replacement Therapy: BMS can cause dry mouth, which can further exacerbate symptoms. Saliva replacement therapy can help to keep the mouth moist and relieve symptoms.</li>
	<li>Behavior Modification: Certain behaviors such as drinking alcohol, smoking, or consuming spicy or acidic foods can exacerbate BMS symptoms. Avoiding these triggers can help to manage symptoms.</li>
	<li>Cognitive-Behavioral Therapy: In some cases, cognitive-behavioral therapy (CBT) can help manage BMS symptoms. CBT can help to address the anxiety and depression that often accompany BMS. 
	&nbsp;</li>
</ol>

It is important to note that there is no one-size-fits-all treatment for BMS, and what works for one person may not work for another. Treatment should be tailored to the individual&#39;s specific needs and may involve a combination of approaches. 
&nbsp;

Burning mouth syndrome (BMS) is a condition that can significantly impact a person&#39;s quality of life and may lead to several complications, including: 
&nbsp;

<ol>
	<li>Depression And Anxiety: BMS can cause significant discomfort and pain, which may lead to depression and anxiety in some individuals.</li>
	<li>Difficulty Eating And Drinking: BMS can make it difficult to eat and drink, leading to weight loss and malnutrition in some individuals.</li>
	<li>Sleep Disturbances: BMS can cause sleep disturbances due to pain and discomfort.</li>
	<li>Social Isolation: BMS can cause embarrassment and social isolation due to difficulty speaking, eating, and drinking.</li>
	<li>Chronic Pain: BMS can cause chronic pain, which can be difficult to manage and may require ongoing treatment.</li>
	<li>Medication Dependence: Some individuals with BMS may become dependent on pain medications to manage their symptoms. 
	&nbsp;</li>
</ol>

There are several risk factors associated with the development of burning mouth syndrome (BMS), including: 
&nbsp;

<ol>
	<li>Gender: BMS is more common in women than in men.</li>
	<li>Age: BMS is more common in middle-aged and older adults.</li>
	<li>Menopause: BMS is more common in postmenopausal women.</li>
	<li>Nutritional Deficiencies: Deficiencies in certain vitamins and minerals, such as vitamin B12 and iron, may contribute to the development of BMS.</li>
	<li>Psychological Factors: Stress, anxiety, and depression may contribute to the development of BMS in some individuals.</li>
	<li>Oral Infections: Certain oral infections, such as thrush (a fungal infection), may cause BMS.</li>
	<li>Allergies: Some individuals with BMS may have allergies to certain foods or dental materials.</li>
	<li>Medications: Certain medications, such as those used to treat high blood pressure, may cause BMS as a side effect.</li>
	<li>Previous Dental Work.</li>
	<li>Chronic medical conditions, such as Parkinson&rsquo;s disease, fibromyalgia, and autoimmune disorders. 
	&nbsp;</li>
</ol>

There is no known way to prevent burning mouth syndrome, as the underlying cause is often unknown. However, several factors may help to reduce the risk or severity of BMS symptoms<a href="#">[7]</a>: 
&nbsp;

<ol>
	<li>Good Oral Hygiene: Maintaining good oral hygiene, including regular brushing and flossing, may help to prevent oral infections that can contribute to BMS.</li>
	<li>Avoiding Irritants: Avoiding tobacco, alcohol, and spicy or acidic foods may help to reduce irritation in the mouth and prevent BMS symptoms.</li>
	<li>Addressing Nutritional Deficiencies: Addressing nutritional deficiencies, such as those in vitamin B12 and iron, may help to reduce the risk of developing BMS.</li>
	<li>Managing stress: Managing stress and anxiety may help to reduce the severity of BMS symptoms in some individuals.</li>
	<li>Regular Dental Checkups: Regular dental checkups can help to identify and address any oral health issues that may contribute to BMS symptoms. 
	&nbsp;</li>
</ol>
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Key Points

<ul>
	<li>Burning mouth syndrome (BMS) is defined as a chronic pain condition that primarily affects postmenopausal women and older adults, causing a burning sensation in the mouth, particularly on the tongue.</li>
	<li>There are two main types of burning mouth syndrome:&nbsp; primary and secondary.</li>
	<li>Primary BMS has no identifiable underlying cause and is believed to be related to damage or dysfunction of the nerves that control pain and taste in the mouth.</li>
	<li>Secondary BMS is associated with an underlying medical condition or medication use.</li>
	<li>Signs and symptoms of BMS include persistent burning sensation in the mouth, typically affecting the tongue, lips, and/or palate; dry mouth (xerostomia) or an unusually increased salivary flow and altered taste (dysgeusia).</li>
	<li>There is no specific diagnostic test for BMS, and diagnosis is usually made based on a patient&#39;s symptoms and medical history.</li>
	<li>A visual examination of the mouth and tongue may reveal signs of inflammation, oral infections, or other conditions that could be causing the symptoms.</li>
	<li>A small sample of tissue may be removed from the affected area for microscopic examination to check for signs of infection or inflammation.</li>
	<li>Salivary rate test is done to measure the amount of saliva produced by the salivary glands.</li>
	<li>Depending on the individual case, medications such as antidepressants, anticonvulsants, or benzodiazepines may be prescribed.</li>
	<li>Topical therapies such as capsaicin or benzocaine can be applied directly to the affected area to help relieve pain.</li>
	<li>Certain behaviors such as drinking alcohol, smoking, or consuming spicy or acidic foods can exacerbate BMS symptoms.</li>
	<li>It is important to note that there is no one-size-fits-all treatment for BMS, and what works for one person may not work for another.</li>
	<li>BMS can make it difficult to eat and drink, leading to weight loss and malnutrition in some individuals.</li>
	<li>BMS can cause significant discomfort and pain, which may lead to depression and anxiety in some individuals.</li>
	<li>Some individuals with BMS may become dependent on pain medications to manage their symptoms.</li>
	<li>BMS is more common in women than in men.</li>
	<li>Stress, anxiety, and depression may contribute to the development of BMS in some individuals.</li>
	<li>Certain medications, such as those used to treat high blood pressure, may cause BMS as a side effect.</li>
	<li>Maintaining good oral hygiene, including regular brushing and flossing, may help to prevent oral infections that can contribute to BMS.</li>
	<li>Addressing nutritional deficiencies, such as those in vitamin B12 and iron, may help to reduce the risk of developing BMS. 
	 
	&nbsp;</li>
</ul>
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[1] National Institute of Dental and Craniofacial Research. (n.d.). Burning Mouth Syndrome.

[2] Lopez-Jornet P, Camacho-Alonso F, Andujar-Mateos P, Sánchez-Siles M. (2016). Burning mouth syndrome: An update. Journal of Oral Patogholy and Medicine, 45(9): 649-656. doi: 10.1111/jop.12425.

[3] Grushka M, Epstein JB, Gorsky M. (2002). Burning mouth syndrome. American Family Physician, 65(4):615-622. PMID: 11871683.

[4] International Association for the Study of Pain. (2019). IASP Terminology - Burning Mouth Syndrome.

[5] Schiffman, E., Ohrbach, R., Truelove, E., et al. (2014). Diagnostic Criteria for Headache Attributed to Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†