As a feature of CNNhealth.com, our team of expert doctors will answer questions from readers. Here’s a question for Dr. Gupta.
By Karen Burns, Matawan, New Jersey
“My mouth has been on fire for two years! I have burning mouth syndrome. Could you please provide information on this disturbing syndrome? “
Karen, thank you for your question. As you have seen, Burning Mouth Syndrome (SMB) can be a painful and frustrating condition that causes a moderate to severe burning sensation in the mouth that can last for several months to years. Pain can include your tongue, lips, gums, the inside of your cheeks, the roof of your mouth, and it may look like you have scalded your mouth.
While BMS can affect anyone, it’s more common in middle-aged or older women, according to the National Institutes of Health. Some people experience a bitter or metallic taste in their mouth, a dry or sore mouth, or tingling or numbness in their mouth and tongue. According to the Mayo Clinic, pain can take many forms, including starting with mild pain upon waking up, but getting worse over the course of the day, or it can be severe throughout the day, right from the start of the day. It can also come and go, or you can go for days without any pain.
The syndrome is frustrating because it is often difficult or impossible to determine the cause of the burn, making treatment difficult. The possible causes are very varied, including hormonal changes, nutritional deficiencies, oral thrush, acid reflux, ill-fitting dentures or allergy to denture materials, dry mouth caused by drugs or disorders, damage to the nerves controlling pain and taste, excessive irritation of the mouth resulting from excessive brushing of the tongue, excessive use of mouthwash, excessive consumption of acidic drinks, or anxiety and depression.
To diagnose BMS, your healthcare professional may do blood tests to look for signs of nutritional deficiencies, infection, and disorders associated with BMS, including diabetes or thyroid problems. They will also dab your mouth to check for oral thrush. Another option is to test for allergies to denture materials, foods, or other substances that may be causing your condition.
When the cause of BMS cannot be identified, it is referred to as primary or idiopathic burning mouth syndrome. When the cause of BMS can be identified, such as a nutritional deficiency of iron, zinc, one of the B vitamins, or an allergy to denture materials, it is referred to as secondary burning mouth syndrome.
Your treatment for BMS will depend on the cause of the burn. If your dentures are causing irritation, they will need to be adjusted or replaced; if it is due to a medical condition such as diabetes, Sjögren’s syndrome or a thyroid problem, your healthcare professional will treat the underlying condition; supplements will be used to treat a nutritional deficiency; if a prescription medication burns your mouth, switching to a different medication may be an option, and medications may be prescribed to relieve underlying conditions, including anxiety and depression, dry mouth, oral thrush and pain caused by nerve damage.
If no cause can be found for your BMS, your treatment will focus on relieving your pain symptoms. There are also things you can do to relieve pain and dry mouth, including sucking on chunks of ice, chewing sugarless gum to keep your mouth moist, drinking water frequently, brushing. teeth or dentures with baking soda and water, and avoiding alcohol, tobacco, and irritants such as spicy foods, mouthwashes containing drying alcohol, and acidic products like citrus fruits and juices.