Burning Mouth Syndrome: Causes, Symptoms, and Why You Should Consult a Specialist

Introduction

Burning Mouth Syndrome (BMS) is a distressing condition characterized by a persistent burning sensation in the mouth, often without any visible lesions. It commonly affects the tongue, lips, gums, and the inner lining of the cheeks. Many individuals attempt home remedies or ignore the symptoms, leading to prolonged discomfort and undiagnosed underlying conditions such as diabetes, vitamin B12 deficiency, anemia, oral potentially malignant disorders (OPMDs), or oral submucous fibrosis (OSMF).

Understanding BMS, its causes, and the importance of consulting an oral physician or dentist can help in early diagnosis and effective treatment, preventing serious consequences.

Clinical Features of Burning Mouth Syndrome

• Persistent burning sensation in the tongue, lips, gums, palate, and inner cheeks
• Dry mouth (xerostomia) despite normal saliva production
• Altered taste perception, including a bitter or metallic taste
• Increased thirst or discomfort while consuming spicy or acidic foods
• Worsening symptoms throughout the day, often improving during sleep
• Emotional distress, including anxiety and depression due to chronic discomfort

Types of Burning Mouth Syndrome

BMS is categorized into two main types:

Primary BMS (Idiopathic Burning Mouth Syndrome)

• No identifiable cause after thorough medical evaluation
• Often linked to neuropathic dysfunction (nerve-related issues)
• Affects postmenopausal women more frequently

Secondary BMS (Burning Mouth Caused by an Underlying Condition)

• Develops due to an identifiable medical or oral condition
• Often associated with systemic diseases, nutritional deficiencies, or allergic reactions

Causes of Burning Mouth Syndrome

BMS can arise from local or systemic causes, requiring a thorough evaluation.

Local Causes

• Oral infections (fungal infections like candidiasis)
• Dental restorations (reaction to metal fillings or prosthetics)
• Allergic reactions (to toothpaste, mouthwash, or dental materials)
• Oral habits like excessive tongue thrusting or lip-biting
• Dry mouth (xerostomia) due to reduced saliva flow
• Irritation from spicy foods, alcohol, or tobacco use

Systemic Causes

• Diabetes mellitus (uncontrolled blood sugar affecting nerves)
• Vitamin B12, iron, or folic acid deficiency (nutritional deficiencies)
• Anemia (reduced oxygen supply to oral tissues)
• Thyroid disorders (hypothyroidism or hyperthyroidism)
• Gastroesophageal reflux disease (GERD) (acid irritation in the mouth)
• Hormonal changes (common in postmenopausal women)
• Neurological disorders (nerve damage or dysfunction)

Prevention of Burning Mouth Syndrome

While not all cases can be prevented, following these steps may reduce the risk:

• Maintain good oral hygiene and regular dental checkups
• Avoid irritants such as spicy foods, alcohol, and tobacco
• Stay hydrated to prevent dry mouth
• Ensure a balanced diet rich in vitamins and minerals
• Manage underlying medical conditions like diabetes or anemia
• Use mild, non-irritating toothpaste and mouthwashes

Self-Screening: Steps to Take at Home

If you experience a persistent burning sensation in the mouth, follow these steps:

1. Monitor symptoms—Check if symptoms worsen with certain foods, oral products, or habits.
2. Check for dryness—Observe whether your mouth feels excessively dry.
3. Assess taste changes—Note any metallic or altered taste perception.
4. Review medication history—Some drugs may cause dry mouth or irritation.
5. Check for deficiencies—Look for signs of anemia, fatigue, or vitamin deficiencies.
6. Avoid self-medication—Do not use over-the-counter treatments without professional guidance.
7. Consult a specialist—If symptoms persist, visit an oral physician, dentist, or physician to rule out serious underlying conditions.

Investigations for Burning Mouth Syndrome

To determine the cause of BMS, healthcare professionals may recommend:

• Complete oral examination to check for infections or lesions
• Blood tests to assess vitamin levels, iron, thyroid function, and diabetes
• Salivary flow tests to check for dry mouth
• Allergy testing to identify reactions to oral products
• Biopsy (if needed) to rule out potentially malignant disorders

Treatment of Burning Mouth Syndrome

Medical and Dental Management

• For local causes:
  • Treat oral infections (e.g., antifungal therapy for candidiasis)
  • Change irritating dental materials if necessary
  • Manage dry mouth with saliva substitutes and increased hydration
• For systemic causes:
  • Control diabetes, thyroid disorders, and anemia
  • Correct nutritional deficiencies with supplements
  • Prescribe medications for neuropathic pain (if nerve dysfunction is suspected)

Lifestyle Modifications

• Avoid spicy, acidic, and extremely hot foods
• Stop smoking and limit alcohol consumption
• Use a mild fluoride toothpaste without sodium lauryl sulfate (SLS)
• Manage stress and anxiety through relaxation techniques

When to Seek Professional Help?

If you notice persistent burning sensations in your mouth, consult a specialist immediately. Avoid self-treatment, as it may worsen the condition or mask an underlying disease. In such cases, seek help from an oral physician, dentist, or physician for accurate diagnosis and treatment.

Conclusion

Burning Mouth Syndrome is a complex condition that may indicate an underlying systemic or oral disorder. Early detection and proper management can significantly improve symptoms and quality of life. If you experience unexplained oral burning, do not ignore it—consult a specialist for a thorough evaluation.

Frequently Asked Questions (Q&A)

1. Can burning mouth syndrome go away on its own?

In some cases, BMS may resolve if the underlying cause is identified and treated. However, many people require medical intervention for relief.

2. Is BMS a sign of oral cancer?

BMS itself is not cancerous, but it may indicate underlying conditions such as oral potentially malignant disorders (OPMDs). Persistent symptoms should always be evaluated by a specialist.

3. Can vitamin deficiencies cause burning mouth?

Yes, deficiencies in vitamin B12, iron, and folic acid are common causes of burning mouth symptoms.

4. What foods should be avoided if I have BMS?

Avoid spicy, acidic, and very hot foods, as well as alcohol and tobacco, which can worsen symptoms.

5. How long does burning mouth syndrome last?

The duration varies; some cases resolve within months, while others persist for years. Proper diagnosis and treatment can help manage symptoms effectively.

6. Who should I consult for BMS?

Consult an oral physician, dentist, or general physician to determine the cause and receive proper treatment.