Mouth on Fire? Tips to Cool Down Burning Mouth Syndrome

Do you have a burning sensation in your mouth that doesn’t go away? Or does it come and go, but you have no clue what is causing it? Burning mouth syndrome causes an intense, burning feeling on the tongue, lips, cheeks, or the roof of your mouth. Some studies suggest it can affect more than 18% of the population. Burning mouth syndrome can be very complex and hard to cope with. So, let’s explore some possible causes, available treatments, and common myths about this debilitating condition.

Why is your mouth burning?

Burning mouth syndrome (BMS) can feel like burning your mouth with hot food or a drink, but it often occurs daily without an obvious cause. It usually appears suddenly, but sometimes it can develop slowly over time. It can affect anyone, but women are seven times more likely than men to experience this condition. Specifically, women between the ages of 50–70 are at the highest risk.

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BMS can be multifactorial, making this condition very frustrating for patients trying to determine the cause.

Types of burning mouth syndrome

There are two main types of BMS based on what causes the condition:

  • Primary burning mouth syndrome. The cause of BMS is unknown or unrelated to a different medical condition. Some experts suggest it may be related to nerve damage.
  • Secondary burning mouth syndrome. Usually related to an underlying medical condition. Often, treating the medical condition helps alleviate the burning symptoms.

Do I have burning mouth syndrome?

Burning mouth syndrome can be more than just a temporary burning sensation in your mouth, tongue, and roof of the mouth. Other symptoms include:

  • Tingling or numbness
  • Xerostomia or dry mouth
  • Altered taste
  • Trouble sleeping
  • Medical issues
  • Psychological disorders.

Symptoms can persist constantly but often come and go throughout the day. While BMS is not contagious, it can last for months or even years. However, diagnosing BMS can be tricky since no clinical signs can be seen during an examination.

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Your dentist or doctor should thoroughly examine your history and risk factors. This can include:

  • Blood test for deficiencies or underlying medical issues
  • Allergy testing
  • Assess salivary flow
  • Biopsy
  • Specialty imaging.

A complete examination can help rule out other possible causes before diagnosing BMS.

What causes burning mouth syndrome?

BMS can be complex and can be related to systemic, local, and psychological factors. Some studies suggest primary BMS is an actual syndrome and secondary BMS is more of a symptom of another medical condition.

Primary BMS often involves damage to the nerves that control pain and taste. It most commonly involves the elderly and postmenopausal women. Accurately diagnosing primary BMS is more complex as it involves specialized testing of the nerves and neuropathways.

Other medical conditions usually cause secondary BMS. Treating the medical issue relieves the symptoms of BMS. Secondary BMS can be related to:

  • Teeth grinding or jaw clenching
  • Depression
  • Menopausal hormone changes
  • Diabetes
  • Thyroid issues
  • Allergies to foods or dental products
  • Metal allergies (common in dental restoratives)
  • Severe dry mouth related to Sjögren’s syndrome or radiation
  • Oral yeast infections, common with denture wearers
  • Acid reflux
  • Low vitamin D
  • Low hemoglobin, iron, and vitamin B12

Can medications be the cause?

There are several medications that cause burning mouth syndrome. These include:

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  • Hormone replacement medications
  • Some selective serotonin reuptake inhibitor (SSRI) medications for anxiety or depression, like fluoxetine and sertraline
  • Many blood pressure medications, including lisinopril
  • Antiviral drugs, like efavirenz
  • Medications to control seizures, like topiramate or clonazepam

BMS caused by medications seems to be dose-related and occurs more often as the dose is increased. If you suspect a medication is causing your BMS, speak with your doctor before you make any changes. Your doctor may have suggestions to help relieve your symptoms.

How to manage burning mouth syndrome?

Treating BMS depends greatly on uncovering the cause first. Then, your dentist or doctor can accurately treat and possibly cure the symptoms.

Oral habits like clenching and grinding are common in people with BMS. A custom night guard can help manage these oral habits and may help relieve some of the painful symptoms of BMS.

Topical medications may be prescribed for patients with oral yeast infections. Oral yeast infections are common under dentures and oral appliances. Therefore, removing appliances for an extended period daily and properly disinfecting them is also important. Your dentist can recommend products for your specific appliance.

For many patients, a vitamin supplement significantly reduces symptoms. A study in 2021 found that taking a vitamin B complex and a zinc supplement significantly lowered BMS symptoms in patients with vitamin deficiencies. Furthermore, some patients added a topical capsaicin rinse and had even fewer BMS symptoms.

BMS can also be related to allergies. Foods, dental products, and even dental materials are all common. Some ingredients in toothpaste and mouth rinse can cause an allergic reaction. In rare cases, some individuals may be allergic to the dental material used for restorations. These are commonly metal allergies and may require replacing restorations. Your dentist can help determine the right treatment in these situations.

Properly managing underlying medical issues like diabetes, acid reflux, depression, hormone imbalances, and thyroid issues helps reduce BMS symptoms. Therefore, make sure to discuss any painful, burning sensations you are having.

When to seek professional help?

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Burning mouth syndrome can be very debilitating. Often, it is a symptom of a more serious medical condition. Therefore, it is important to talk to a professional if burning sensations last for months or continue to recur without an apparent cause. A thorough oral and medical examination is vital to diagnose the cause accurately. The underlying issue may go undetected for a long time without proper testing and evaluation. Treating the true issue is vital to curing many BMS cases.

Common myths about BMS

While BMS is very complex, here are a few misconceptions about this painful disorder.

1. BMS is caused by poor oral hygiene

BMS can be related to a wide array of issues. While oral hygiene is obviously very important, failing to brush your teeth is not a cause of developing this condition. Oral hygiene may play a small part in some cases of BMS involving denture wearers.

A condition called denture stomatitis can occur in those who wear dentures and partials. Denture stomatitis is an oral infection caused by the overgrowth of yeast. It is especially common in patients who do not remove their appliances daily. Yeast thrives in warm, dark, and moist areas, like under a denture. Denture stomatitis often causes bright red tissue and a severe burning sensation on the roof of the mouth.

Therefore, it is necessary to remove the appliance for an extended period daily and thoroughly disinfect it. Often, patients choose to remove appliances while they sleep and soak the appliance in a cleaner. This improves oral hygiene, reduces yeast, and helps prevent BMS associated with dentures.

2. There are no effective burning mouth syndrome treatments

Treating BMS can be complex and sometimes requires trial and error. Currently, there are no treatments specific to BMS. In order to effectively treat BMS, it is important to identify the true cause of BMS. In many cases, once the underlying medical issues are addressed, the symptoms of BMS completely disappear. Antidepressants, antiepileptics, analgesics, and oral mucosa protectors are commonly used as burning mouth syndrome medications to help alleviate the symptoms.

3. Spicy foods can cause BMS

Spicy foods do not cause BMS. However, spicy foods may temporarily make the symptoms of BMS more noticeable. Certain foods or drinks can make the tongue and lips burn more, but usually, this goes away shortly after eating. Here are some things to avoid with BMS:

  • Spicy foods
  • Mouthwash with alcohol
  • Fruit juices or citrus fruits
  • Acidic foods like tomatoes
  • Carbonated drinks
  • Tobacco products
  • Alcoholic drinks

4. Chewing gum continuously can cure BMS

Chewing gum cannot cure BMS. However, a study showed chewing gum can help alleviate the pain associated with BMS. Since BMS is usually a symptom of another medical condition, treating the underlying cause of BMS is the only effective way to cure it. Here are some burning mouth syndrome self-care tips that may provide some instant relief from burning mouth syndrome symptoms:

  • Stay hydrated
  • Suck on ice chips
  • Sip on a cold drink
  • Try meditation to help reduce stress and relax
  • Switch toothpaste to a flavor-free or sensitive type
  • Avoid acidic, alcoholic, or spicy foods

If these do not help, your doctor may prescribe a lidocaine mouth rinse that can help numb your mouth.

Overall, burning mouth syndrome can be intense and very difficult to deal with. Finding solutions that work for you may take time. Unfortunately, there is not one test that can confirm BMS. But with the help of a dedicated professional, finding the answers to what is causing BMS can help eliminate your oral pain and improve your overall health.

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