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Burning Mouth Syndrome: The distasteful and uncomfortable condition

Dec 22, 2019 Dr Zulfikar Bux, Features / Columnists

By Dr. Zulfikar Bux
Assistant Professor of Emergency Medicine

Burning mouth syndrome (BMS) is a condition that causes pain and discomfort in your mouth, lips, or tongue. While it is not as common, it is very uncomfortable for patients that are affected by it. The feeling is often described as a burning, scalding, or tingling sensation in the mouth. It affects about 2-4 % of the population and women are more likely to be affected by it than men. It is found more in women during or after menopause. The cause of BMS can be hard to pin down. Some people may have symptoms for months or years and never know why. Today we will see if we can shed some light on this bothersome condition.

WHAT ARE SYMPTOMS OF BURNING MOUTH SYNDROME?

Some people with BMS report symptoms appearing suddenly. For others, they may develop gradually over time. Typical symptoms of BMS include:
• Burning feeling in the mouth, tongue, or lips
• Dry mouth
• Bitter or metallic taste
• Loss of taste
BMS may occur every day, or it may come and go. Some people wake up with pain and it lasts all day. Others wake up with little pain but it gets worse as the day progresses. Regardless of the pattern, the symptoms may last for months to years.

WHAT CAUSES BURNING MOUTH SYNDROME?

The exact cause for burning mouth syndrome is unknown. Cases have been linked to:
• Nerve damage
• A dental procedure
• Nutritional deficiency (such as iron, zinc, or some B vitamins)
• Menopause or other hormonal changes
• Certain medicines used to treat high blood pressure
• Extreme allergic reactions
• Acid reflux
• Oral yeast infection (thrush)
• Mental disorders such as anxiety or depression
Many times, more than one cause is present. Sometimes doctors can’t find the cause.
You are at higher risk of developing BMS if you are:
• A woman
• Post-menopausal
• Over age 50

HOW IS BURNING MOUTH SYNDROME DIAGNOSED?

There is no simple way to test for BMS. Your doctor will examine your mouth and ask about your medical history and symptoms. This will help better pinpoint a possible cause. They may perform tests to rule out other possible issues. This could include an oral swab to check for thrush. It may also include blood tests to check for conditions such as diabetes, thyroid issues, or mineral deficiencies.

WHAT ARE THE TREATMENT OPTIONS?

There is no specific cure for burning mouth syndrome. The best thing you can do is address your symptoms. Treatment is based on your symptoms, their severity, and the underlying cause. Possible treatment options include:
•Products to produce saliva and relieve dry mouth
• Vitamin supplements (such as iron, zinc, or vitamin B) to provide nutrition
• Oral pain relief ointments
• Depression or anxiety medicines to relieve pain and improve your nervous system
If your doctor thinks a certain medicine is causing BMS, they might suggest switching to a new one.
If your doctor can’t find a cause, they may recommend trying oral thrush medicines, B vitamin supplements, or antidepressants. These have been found to be effective in treating BMS.
Most cases of BMS improve on their own. Additional tips for easing your symptoms include:
• Sucking on ice chips
• Drinking plenty of liquids
• Avoiding hot and spicy foods
• Avoiding foods and drinks that are high in acid, like citrus fruit, soda, and coffee
• Avoiding alcohol and tobacco products
• Avoiding products that contain alcohol
• Trying a new brand of toothpaste
As you can see, BMS is still not as understood in the medical world. If you have or suspect that you have BMS, your best chance lies in educating yourself about it so that you can collaborate with your doctor to give you the best chance of overcoming this distasteful condition.

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