The burning mouth syndrome or burning mouth syndrome gives a painful or burning sensation in the mouth and tongue. The ‘burning mouth syndrome’ (BMS) is a relatively rare, yet extremely unpleasant condition, characterized by a bilateral burning sensation of the oral mucosa with no apparent mucosal changes. The cause is unknown. BMS is much more common in women than in men.
The syndrome mainly manifests itself above the age of 40. There is no proven effective treatment available. You can take all kinds of measures to reduce the symptoms of burning mouth syndrome. For example, you can prevent burning mouth syndrome by not smoking, avoiding spicy food, not drinking alcohol, etc.
The burning mouth syndrome
Burning mouth syndrome (BMS) is also known as burning mouth syndrome. BMS is a chronic burning pain in the mouth. The pain can affect the tongue and mucous membranes of the oral cavity. This is often accompanied by a metallic taste, a salty or even bloody taste in the mouth, and a dry mouth. The pain can be severe as if the mouth has been burned.
It is unknown what causes burning mouth syndrome. No abnormalities are visible on the tongue or mucous membranes. The nature and character of the complaints can differ greatly from patient to patient. When the symptoms are limited to the tongue, it is called glossodynia.
Burning mouth syndrome symptoms
The symptoms often come on suddenly. The symptoms of burning mouth syndrome include:
- An annoying burning sensation on both sides of the tongue, lips, gums, palate, throat, or even entire mouth.
- A prickling, tingling, or numbness in the mouth or on the tip of the tongue.
- A dry mouth (while on examination of the mouth, the moistening of the mucous membrane seems to be quite normal).
- Taste changes: metallic taste in the mouth, or a salty or bloody taste in the mouth.
- Loss of taste.
- Pain in the mouth.
- The pain in the mouth worsens as the day progresses.
- More Thirsty.
- Swallowing problems.
- Teeth grinding while sleeping.
The nature and severity of the complaints vary per person.
Patients very often describe their complaints as if they had burned their mouth or tongue on food that was too hot. The nature and severity of the complaints vary per patient. The complaints almost always occur every day, with a worsening of the complaints during the course of the day.
The complaints can also be intermittent, where there can even be a number of completely pain-free days. Most patients suffer from burning mouth syndrome on a daily basis, for several months and sometimes even years. Over the years, complaints often decrease. In some patients, the complaints persist for many years and, in very exceptional cases, even for life.
Depression and back pain
Research shows that patients with burning mouth syndrome more often suffer from depression and chronic lower back pain, while these complaints do not seem to be related to the complaints about burning mouth syndrome.
Complications of burning mouth syndrome include:
- Difficulty falling asleep and lack of success ;
- problems with eating and weight loss;
The risk factors of BMS are:
- Gender: women are more often affected than men;
- After menopause;
- You are over 50 years old.
Burning mouth syndrome or burning mouth syndrome usually begins spontaneously, with no known trigger. However, certain factors can increase your risk of developing burning mouth syndrome, including:
- Recent illness;
- Previous dental treatment;
- wearing dentures;
- Allergic reactions to food;
- Traumatic life events;
Burning mouth syndrome causes
The cause of burning mouth syndrome is classified as either primary or secondary.
Primary burning mouth syndrome
When no clinical or laboratory abnormalities can be identified, the condition is called primary or idiopathic burning mouth syndrome. Some researchers suggest that burning mouth syndrome is related to problems with sensory and taste nerves of the peripheral or central nervous system. In that case, the cause is neurological in nature.
Secondary burning mouth syndrome
Sometimes burning mouth syndrome is caused by an underlying medical condition. In these cases, it is called secondary burning mouth syndrome.
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Causes of secondary burning mouth syndrome
BMS due to disorders
Causes of burning mouth with visible mucosal changes are:
- Candidiasis: A yeast infection.
- Geographic tongue or lingua geographical: a harmless condition of the tongue.
- Mucocutaneous disorders: disorders related to the skin and mucous membranes and in this case where the abnormalities of the oral mucosa may be accompanied by a sensation of burning: lichen planus, erythema multiforme, pemphigus vulgaris, and mucosal pemphigoid.
- Stomatitis: a painful inflammation of the oral mucosa and tongue.
A dry mouth (xerostomia), can be caused by various medications, health problems, problems with salivary gland function, or the side effects of chemotherapy.
Drinking alcohol as well as using mouthwash with alcohol may cause or exacerbate the burning symptoms in your mouth.
Nutritional deficiencies, such as deficiency of iron, zinc, folic acid, vitamin B1, vitamin B2, vitamin B6, and vitamin B12, can cause a burning sensation in the mouth.
Dentures can cause discomfort, especially if they don’t fit properly, especially if they don’t fit properly, which can put pressure on some of the muscles and tissues of the mouth. Burning mouth syndrome can also be caused by dentures that contain materials that irritate the tissues of your mouth.
Allergy or reaction to foods
Allergies or reactions to foods, food flavors, food additives, fragrances, and dyes can cause burning mouth syndrome.
Reflux of stomach acid
Reflux of stomach acid (gastroesophageal reflux disease or GERD) from the stomach to the mouth can cause a burning sensation in the mouth and recurring complaints.
Certain medications, especially high blood pressure medications, can cause burning mouth syndrome.
certain habits, such as tongue biting, lip biting, tongue tip biting, and teeth grinding (bruxism), are other possible triggers of burning mouth syndrome.
Endocrine disorders, such as diabetes or an underactive thyroid gland (hypothyroidism), can contribute to burning mouth syndrome.
Irritation in the mouth
Excessive mouth irritation, which can result from brushing your tongue frequently, using abrasive tubes of toothpaste, overusing mouthwashes, or too many acidic drinks, can also cause a burning mouth.
Psychological factors, such as anxiety, depression, or stress, can cause symptoms such as a burning tongue.
Smoking irritates the oral mucosa and can cause tongue burns.
Examination and diagnosis
The diagnosis can only be made by first ruling out other conditions that cause oral complaints. If other causes have been excluded, no visible mucosal abnormalities have been identified that could indicate a primary mucosal disorder or an underlying systemic disorder, the patient still complains of a burning sensation on both sides in the mouth and the complaints persist for more than six months, it is called BMS.
Interview and physical examination
The doctor will review your medical history, examine your mouth and ask questions about the symptoms you are experiencing, your oral habits, and how you care for your mouth and teeth. In addition, he or she will likely perform a general medical exam, looking for signs of any underlying conditions.
As part of the diagnostic process, your doctor may require you to have some of the following tests:
- Blood test: complete blood count. This is a blood test that can be requested to detect abnormalities in the blood.
- Other blood tests. Because a nutritional deficiency is a possible cause of a burning mouth, the doctor may take blood samples to check blood levels of iron, zinc, and some B vitamins. Because diabetes can cause a burning mouth, your doctor may check your blood sugar.
- Allergy tests. The doctor may suggest allergy testing to see if you might be allergic to certain foods, additives, or even substances in dentures.
- Oral swab or biopsy. If the doctor suspects that a fungus is involved, he or she may take a small piece of tissue (biopsy) or a smear to be examined in the laboratory.
Because burning mouth syndrome is associated with such a wide variety of medical conditions, your primary care physician may refer you to a specialist for screening and diagnosis, and possibly treatment. The care team may consist of an ENT specialist, a dermatologist, a dentist, a psychiatrist, or a psychologist.
Burning mouth syndrome treatment
Because the cause is unclear, there are no effective, root-directed treatment options for this syndrome. There is no proven effective treatment method available so far. In practice, it mainly comes down to a good explanation and reassurance that there is no malignant disease.
Neuropathic pain medication can relieve the symptoms. A recent study of BMS patients suggests that antidepressants and anxiolytics (anti-anxiety drugs) may provide some improvement in symptoms in some people. Psychological support and relaxation therapy can also help reduce the symptoms.
The type of treatment depends on the underlying cause.
Dry mouth (xerostomia)
Treating the cause of your dry mouth—for example, Sjögren’s syndrome, taking certain medications, or another cause—can relieve burning mouth symptoms. In addition, drinking more fluids or taking a medication that promotes saliva flow may help. Your doctor can prescribe this.
If the cause is a fungal infection, the doctor can prescribe oral antifungal medicines. If you wear dentures, it is wise to have them checked by the dentist.
For a burning mouth that may be caused by or associated with psychological factors such as anxiety and depression, the doctor may recommend antidepressant medication or psychiatric treatment, or a combination of both.
Nutritional deficiencies can be corrected by taking supplements containing B vitamins and minerals, such as zinc and iron.
Your dentist may be able to adjust your dentures so that they are less irritating to the mouth. If your dentures contain substances that irritate your oral tissues, you may need a different denture. You can also improve symptoms by practicing good dental care, such as taking dentures out at night and cleaning them properly.
Nerve disruption or damage (neuropathy)
The doctor may recommend medicines to relieve nerve pain, including benzodiazepines such as clonazepam, tricyclic antidepressants such as amitriptyline or nortriptyline, or an antiepileptic such as gabapentin. For pain relief, the doctor may also recommend that you rinse your mouth with water and capsaicin, the substance that makes peppers so hot.
Avoiding foods that contain allergens that can irritate the tissues of your mouth can also help.
If you’re on a medication that causes a burning mouth, switching to an alternative may help. Do this in consultation with your doctor.
Tongue biting and teeth grinding can be helped with mouth guards, medications, and relaxation techniques.
If a burning mouth is associated with conditions such as diabetes or hypothyroidism, treating these conditions may improve your symptoms.
If doctors can’t determine the cause of your symptoms, they may still recommend antifungal drugs, B vitamins, or antidepressants. These medications have been shown to be effective in treating burning mouth syndrome.
In the short term, you can often alleviate the symptoms by avoiding irritating substances, such as alcohol-based mouthwashes, cinnamon or mint products, and cigarette smoke. Chewing sugar-free gum and sucking on popsicles can also help. Other tips to reduce the symptoms of burning mouth syndrome are:
- Avoid alcohol;
- Use toothpaste for sensitive teeth or toothpaste without flavor enhancers;
- Eat healthy and varied;
- Drink cool liquids during the day;
- Exercise daily;
- quit smoking ;
- Reduce stress;
- Avoid acidic or spicy foods.
Prevention of BMS
There is no known way to prevent burning mouth syndrome. But by avoiding tobacco, acidic foods, spicy foods, carbonated drinks, and excessive stress, you may be able to reduce the discomfort of burning mouth syndrome or prevent the symptoms from getting worse.