Burning mouth syndrome

Symptoms of burning mouth syndrome may include severe burning or tingling in the mouth which may persist or come and go over the course of months to years. The tongue is usually affected, but the pain may also be in the lips, gums, palate, throat or whole mouth. The burning sensation may be absent in the morning and increase over the course of the day, start first thing in the morning and last all day, or come and go all day long. For many, the pain is reduced when eating or drinking.  Other symptoms may include a sensation of dry mouth with increased thirst, a bitter or metallic taste, or loss of taste. ^[1][2]

Burning mouth syndrome can be primary or secondary. Some research suggests that primary burning mouth syndrome is caused by damage to the nerves that control pain and taste. Secondary burning mouth syndrome is usually caused by an underlying medical condition. Some of the problems that have been linked to secondary burning mouth syndrome include:^[1][2] 

• Dry mouth, which can be caused by various medications or underlying health problems
• Other oral conditions, such as fungal infections, oral lichen planus, or geographic tongue
• Nutritional deficiencies, such as lack of iron, zinc, folic acid, thiamin, riboflavin, pyridoxine, and cobalamin
• Dentures, especially if they don't fit well and irritate the mouth
• Allergies or reactions to foods, additives, dyes or dental work
• Certain medications, in particular those for high blood pressure
• Oral habits such as tooth grinding, tongue thrusting, or biting of the tongue 
• Endocrine disorders, such as diabetes or hypothyroidism
• Excessive mouth irritation which may result from over-brushing, use of abrasive toothpastes, over use of mouthwashes, or drinking too many acidic drinks
• Psychological factors, such as anxiety, depression, or stress

For many people, the underlying cause of burning mouth syndrome can not be identified.^[1][2]

If the underlying cause of burning mouth syndrome is determined, treatment is aimed at the triggering factor(s). If no cause can be found, treatment can be challenging. The following are potential therapies for burning mouth syndrome; we strongly recommend that you work with your health care provider in determining which therapy is right for you.^[2]  

• A lozenge-type form of the anticonvulsant medication clonazepam (Klonopin)
• Oral thrush medications
• Medications that block nerve pan
• Certain antidepressants
• B vitamins
• Cognitive behavioral therapy
• Special oral rinses or mouth washes
• Saliva replacement products 
• Capsaicin

In addition to these medications, the following measures may be helpful in reducing symptoms of burning mouth syndrome:^[1]

• Sip water frequently
• Suck on ice chips
• Chew sugarless gum
• Avoid irritating substances like tobacco, hot or spicy foods, alcoholic beverages, mouthwashes that contain alcohol, and products high in acid, like citrus fruits and juices, as well as cinnamon or mint.