Diseases

BMS (Burning Mouth Syndrome) Information

Burning mouth syndrome facts*

*Burning mouth syndrome facts medical author: Benjamin Wedro, MD, FACEP, FAAEM

• Burning mouth syndrome (BMS) describes a painful sensation of the tongue, lips, or palate. It also may involve a general sensation of discomfort of the whole mouth.
• The cause of burning mouth syndrome is not known; BMS is not itself a disease but describes symptoms.
• In addition to pain, other BMS symptoms may include
  • tingling or numbness,
  • a metallic taste,
  • alterations in the taste sensation (dysgeusia), and
  • dry mouth (xerostomia).
• There are many different potential causes of burning mouth syndrome, and diagnosis may require examination of the mouth, as well as evaluation for illnesses and diseases that can affect other organs of the body. As of now, BMS is a diagnosis of exclusion, meaning that other causes of mouth pain need to be excluded.
• Other causes of mouth pain may be due underlying diseases like diabetes, thyroid disorders, and vitamin deficiencies, mechanical problems like poorly fitting dentures, or medications including high blood pressure medications (ace inhibitors and angiotensin receptor inhibitors) and antiviral drugs. Tobacco and alcohol use need to be considered as potential causes of mouth pain.
• Burning mouth syndrome can be diagnosed only when no other underlying cause of mouth pain is found.
• Because there is no specific cause for BMS, different treatment options might be considered and would be individualized for each patient.
• Some recommended home remedies include capsaicin, mineral and vitamin supplements (B, folate, zinc, and iron), and chewing sugar-free gums containing sorbitol to stimulate saliva formation.

Diagnosis

BMS is hard to diagnose. One reason is that people with BMS often don't have a mouth problem that the doctor or dentist can see during an exam. Your dentist or doctor may refer you to a specialist. Specialists who diagnose BMS include dentists who specialize in oral medicine or oral surgery. Other specialists include doctors who are ear, nose, and throat specialists; gastroenterologists; dermatologists; neurologists; rheumatologists; and/or allergists.The dentist or doctor will review your medical history and examine your mouth. A lot of tests may be needed. Tests may include:

• Blood tests to check for certain medical problems
• Oral swab tests
• Allergy tests
• Salivary flow test
• Biopsy of tissue
• Imaging tests

Helpful Tips

To help ease the pain of BMS, sip a cold beverage, suck on ice chips, or chew sugarless gum.Avoid irritating substances, such as...

• Tobacco
• Hot, spicy foods
• Alcoholic beverages
• Mouthwashes that contain alcohol
• Products high in acid, such as citrus fruits and juices

Key Points

• Burning mouth syndrome is burning pain in the mouth that may occur every day for months or longer.
• Doctors and dentists do not have a specific test for burning mouth syndrome, which makes it hard to diagnose. Your doctor or dentist will rule out other conditions before diagnosing burning mouth syndrome.
• No specific treatment works for all people. However, your doctor can prescribe medicine to help you manage mouth pain, dry mouth, or other symptoms.

Primary and Secondary BMS

Primary BMS: If tests do not reveal an underlying medical problem, the diagnosis is primary BMS. Experts believe that primary BMS is caused by damage to the nerves that control pain and taste.Secondary BMS: Certain medical conditions can cause BMS. Treating the medical problem will cure the secondary BMS. Common causes of secondary BMS include...

• Hormonal changes (such as from diabetes or thyroid problem)
• Allergies to dental products, dental materials (usually metals), or foods
• Dry mouth, which can be caused by certain disorders (such as Sjogren's syndrome) and treatments (such as certain drugs and radiation therapy)
• Certain medicines, such as those that reduce blood pressure
• Nutritional deficiencies (such as a low level of vitamin B or iron)
• Infection in the mouth, such as a yeast infection
• Acid reflux

Symptoms

The main symptom of burning mouth syndrome (BMS) is pain in the mouth that is burning, scalding, or tingling. Or, the pain may happen with a feeling of numbness, which comes and goes. Other symptoms include dry mouth or altered taste in the mouth.BMS is a painful condition. Usually, the tongue is affected, but the pain may also be in the lips or roof of the mouth, or throughout the mouth.BMS pain can last for months or years. Some people feel constant pain every day. For others, pain increases throughout the day. For many people, the pain is reduced when eating or drinking.

Treatment

Your doctor will help you get relief. Medicine can help control pain and relieve dry mouth.Because BMS is a complex pain disorder, the treatment that works for one person may not work for another.Symptoms of secondary BMS go away when the underlying medical condition, such as diabetes or yeast infection, is treated. If a drug is causing secondary BMS, then your doctor may switch you to a new medicine.