Burning mouth syndrome

Burning mouth syndrome (BMS) causes pain that feels like you burned your mouth with a hot drink or scalding food, but there are no signs of damage to the inside of your mouth and there’s no known trigger for the burning sensation. This syndrome is also known as glossodynia. Doctors don’t know what causes burning mouth syndrome, but they think it may be linked to problems with nerves that control pain and how things taste. A secondary form of BMS is related to diseases like acid reflux or diabetes. If a cause is found, treating the condition will improve your symptoms. If no cause is found, lifestyle changes, therapy, and medications can help stop the burning feeling.

Penn Medicine Oral and Maxillofacial Surgery specialists provide comprehensive care for conditions that affect your mouth, teeth, jaw, and face. Our experts can diagnose burning mouth syndrome, along with any conditions that may cause it, and recommend the most appropriate treatments for you.

There are two types of burning mouth syndrome, depending on whether there’s a clear cause of your mouth pain. When you have primary burning mouth syndrome, there’s no apparent cause of your symptoms. Research suggests the pain may be related to damaged nerves that affect pain signals and taste, but it’s not a proven cause. With secondary burning mouth syndrome, another condition causes the burning sensation in your mouth. You might even have more than one condition that can lead to burning mouth syndrome. 

Symptoms of burning mouth syndrome are most common in people assigned female at birth and people who are around 60 and older. Your symptoms may begin gradually or suddenly, and they may occur daily or come and go. Some people have constant pain all day, while others experience mild pain in the morning that gets worse as the day goes on.

Symptoms of BMS may include:

• Burning lips and tongue, or a hot or scalding feeling in your whole mouth, just the roof of your mouth, or on your gums
• Tingling or numbness in your mouth
• Pain that gets better when you eat or drink
• A dry mouth and feeling thirsty
• Loss of taste or a metallic or bitter taste

Causes of BMS vary and can include:

• Acid reflux, also known as gastroesophageal reflux disease (GERD)
• Hormonal changes after menopause
• Conditions that affect the mouth, like a fungal infection known as oral thrush, dry mouth, or a herpes infection
• Nutritional deficiencies, including having too little iron, zinc, or B vitamins in the body
• Serious allergies or allergic reactions to food, fragrances, dyes, or dental products
• Diabetes or thyroid conditions
• Stress, depression, or anxiety
• Oral habits like grinding your teeth, clenching your jaw, biting the tip of your tongue, or pushing your tongue against your teeth
• Mouth irritation from overusing mouthwash, consuming acidic foods or drinks, or other causes
• Medicines, including angiotensin-converting enzyme (ACE) inhibitors that treat high blood pressure

If you think you have burning mouth syndrome, start by seeing your dentist. Your dentist can check for conditions that may be causing your pain, like dry mouth, oral thrush, or mouth sores. Your dentist can also look for signs that you grind your teeth or have other oral habits that may lead to a painful mouth. Your dentist might recommend that you see a specialist who can help diagnose and treat burning mouth syndrome. Your health-care providers will examine your mouth and ask about your medical history.

You might also need tests that can help identify the cause of your symptoms, such as allergy testing, blood tests, oral swabs, gastric reflux testing, salivary assessments, or a biopsy of the tissue.

For some people, simple daily habits can help cool your mouth. These include sipping water or sucking on ice chips throughout the day, changing your brand of toothpaste or other oral care products, and avoiding alcohol, tobacco, and hot and spicy foods and drinks.

For others, it may take time to find the right treatments. If an underlying condition or nutritional deficiency causes your BMS symptoms, your health-care provider will treat the cause. Because burning mouth syndrome can be caused by grinding your teeth or clenching your jaw, your dentist can recommend a custom mouth guard to help you manage oral habits and relieve your pain. If BMS results from taking a medication like an ACE inhibitor, you may need to take a different drug.

Other treatments may also bring relief. A single treatment or a combination of treatments can help improve burning mouth syndrome.