How to Manage Burning Mouth Syndrome (BMS)
Medically reviewed by Brian T. Luong, DMDMedically reviewed by Brian T. Luong, DMDIf you have a tingling or burning sensation in your mouth without any clear reason why, you may have burning mouth syndrome (BMS). The most common symptom of BMS is tongue burning, while some people experience burning lips or tongue burning.A burning sensation around the lips can have other causes, like chapped lips or oral thrush. If these other causes are ruled out, a healthcare provider may diagnose burning mouth syndrome. Burning mouth syndrome is believed to be caused by nerve pain, and the condition can be treated with medications that target nerves.
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Who Gets Burning Mouth Syndrome?Anyone can get burning mouth syndrome, but some people are at increased risk. The condition is rare, impacting just 2% of the population. The exact cause of burning mouth syndrome is unclear.The people most likely to experience burning mouth syndrome are:Women: Women are about 3 to 7 times more likely than men to develop BMS. Most women develop the condition during or after menopause, and it may be associated with the drop in estrogen that occurs at this stage of life. However, treatment with hormones does not typically fix the symptoms of burning mouth syndrome.People with mental illness: People with depression, anxiety, and mood disorders are at higher risk for burning mouth syndrome. They’re more likely to experience symptoms of burning mouth syndrome during or right after having a flare of symptoms from their mental health disorder.People with the following conditions also have increased risk of BMS:Acid refluxAllergies to products or foodsDry mouthTeeth clenching or grinding (bruxism)Mouth infectionsNutritional deficienciesTaking medications, including blood pressure medicationsDiabetes can also cause BMS, although in that cause the burning is considered to be a type of diabetic neuropathy (nerve damage from diabetes).Undiagnosed Burning Mouth Syndrome SymptomsThe main symptoms of BMS is a burning or tingling feeling. This sensation most often occurs on the:Tip and side of the tongueRoof of the mouthInside of the lipsIn addition to the burning sensation, some patients experience additional symptoms including:Sour, bitter, or metallic tasteNumbnessDry mouthChanges to the sense of tasteSymptom Onset and DurationMost people experience a sudden onset of burning mouth syndrome. After the symptoms start, they appear every day, usually for months.The symptoms of burning mouth syndrome may get gradually worse, remain constant, or be sporadic throughout the day. About two-thirds of patients feel better within weeks to months.Secondary EffectsMany people with burning mouth syndrome have trouble getting to sleep or staying asleep. Burning mouth syndrome can also impact your relationship with food because it changes the way certain foods taste. In addition, many people experience symptoms that aren’t directly related to their mouth, including:Back and shoulder painBurning of the skin, including near the genitalsFatigueHeadacheHeart palpitationsIrritable bowel syndromePanic attacksRinging in the earsSelf-Care to Ease DiscomfortBurning mouth syndrome requires medical treatment. Since the pain is linked to nerves, there’s little you can do to soothe flares, though some people find that sucking ice or chewing gum helps.However, one of the best self-care measures for people with burning mouth syndrome is to try to get enough sleep. Sleeping can be difficult for people with burning mouth syndrome, so getting good quality sleep is important. How to Get a BMS Diagnosis Getting a BMS diagnosis can be difficult, but it’s very important. If you have symptoms, talk with your dentist first. They can help identify problems like clenching or grinding your jaw that can contribute to burning mouth syndrome. Ask your healthcare provider if you need to see a specialist dentist, or an ear, nose, and throat specialist (otolaryngologist).Before your healthcare provider can diagnose burning mouth syndrome, they need to rule out other conditions that can cause burning in the mouth. These include:Thrush (oral yeast infection)Lichen planusGeographic tongueIn order to do this, your dentist will look in your mouth. They’ll also ask you for a detailed medical history. It’s important to be honest, because even conditions that don’t seem related—like depression or anxiety—can impact BMS. Your healthcare provider or dentist may also do additional testing, including:Allergy testsBiopsyBlood testsImaging testsOral swab testsSaliva flow testsPrescribed Burning Mouth Syndrome Treatment Healthcare providers treat burning mouth syndrome with medications that target nerves. Many of these are used to treat depression or anxiety as well.The most common treatment for burning mouth syndrome is clonazepam, a type of benzodiazepine. To treat burning mouth syndrome, clonazepam is formulated as a mouthwash. Some people with burning mouth syndrome will also take a clonazepam pill.Other treatments include:Elavil (Amitriptyline)Silenor (Nortriptyline doxepin)Horizant (Gabapentin)It may take time to find the treatment that works for you. Check in with your healthcare provider and communicate about what’s working well, and what isn’t. Managing BMS FlaresThe two over-the-counter (OTC) medications that can help with flares are:Alpha lipoic acid, a supplement taken in pill form that’s been shown to reduce nerve painTopical capsaicin, a cream that can help with nerve painDuring a flare, sucking on ice cubes, sipping a cold drink, or chewing gum may help with symptoms.Treating any underlying health conditions that might contribute to BMS—from temporomandibular joint dysfunction (issues with the joints that connect the lower jaw to the skull) to diabetes—can also help alleviate BMS symptoms. Dental Hygiene and Lifestyle Changes With BMSHygiene can play a role in burning mouth syndrome, and practicing good hygiene may help control symptoms. The most important step is to identify and correct oral behaviors that can contribute to burning mouth syndrome, like clenching or grinding your jaw. In addition, if you have burning mouth syndrome you should avoid substances that can irritate your mouth, including:TobaccoSpicy foodsAlcohol, including the alcohol in certain mouthwashAcidic foods like citrus and juicesSummaryBurning mouth syndrome is a nerve condition that causes a burning or tingling sensation in the mouth, without any clear reason. A dentist can diagnose you with BMS, although they may also refer you to a specialist including an ear, nose, and throat healthcare provider.To diagnose BMS your dentist or medical provider will rule out other causes of burning, and order tests. They can then treat the condition with medications that affect the nervous systems, including antidepressants and benzodiazepines. Read the original article on Verywell Health.
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