- Increased sense of thirst
- Tingling sensations on the tip of the tongue
- Having a dry mouth
- Loss of sense of taste
- A metallic or bitter taste
Burning Mouth Syndrome (BMS) is characterized by a burning sensation in the mouth as if the mouth had been scalded by hot food or drink. It can affect the entire area of the mouth or just portions such as the tongue, the cheeks or the lips. This painful and irritating condition often has no known cause and can last for years. It happens to women almost seven times more often than men, and is found most often in perimenopausal women, the stage leading up to menopause.
Burning mouth syndrome arises from a change within the normally bitter taste on the tip of one’s tongue. When the bitter taste is gone, there’s a loss of inhibition of the pain fibers, so pain is produced immediately. When estrogen levels drop during menopause, they loose their bitter taste buds. Burning Mouth Syndrome is also known as Burning Tongue Syndrome, Scalded Mouth Syndrome, Glossodynia and Stomatodynia.
What is Burning Mouth Syndrome?
The main symptom is the moderate to severe burning sensation in the mouth and tongue. Patients often describe the pain as being less in the morning and getting worse as the day progresses, but this pattern is not universal. In some patients, the pain comes and goes all day, and in others, the pain is present upon awakening and lasts all day. Burning Mouth Syndrome often has no accompanying lesions or deformity in the mouth to indicate an underlying cause.
Two main types of BMS are known. In primary or idiopathic burning mouth syndrome, no underlying cause can be found for the condition. However, in some cases, doctors can find an underlying cause such as nutritional deficiencies or other illness. In these cases, the condition is referred to as secondary burning mouth syndrome.
Causes of Burning Mouth Syndrome
In the case of secondary Burning Mouth Syndrome, the condition can occur from a wide variety of causes. Hormonal changes such as happen in menopause are a common cause, especially the decrease in levels of estrogen. Estrogen is known to be active in the make up of saliva, as well as affecting the bitter taste buds in the back of the mouth. When the bitter taste buds are damaged by the lack of estrogen, researchers think that pain neurons that surround those taste buds become activated.
Other causes of Burning Mouth Syndrome include:
- GERD – Gastroesophageal reflux disease, where the acid from the stomach comes up into the throat and mouth
- Excessive mouth irritation caused by excessive brushing of the tongue, tongue thrusting, teeth grinding, overuse of mouth wash, or excessive consumption of acid based drinks
- Zinc Deficiency
- B Vitamin Deficiency
- High blood pressure medications in the ACE inhibitor class of drugs
- Oral conditions, such as thrush, which is an oral yeast infection or geographic tongue
- Type II Diabetes
- Damage to Tounge and Mouth Nerves
- Iron Deficiency
- Dry Mouth
- Dental disease
- Sensitivities to food
- Oral Cancer
- Sensitivities to food additives, such as dyes, fragrances, flavors or preservatives
- Chronic Infections
Managing Burning Mouth Syndrome
Daily Lifestyle Changes
For primary burning mouth syndrome, lifestyle changes can be some of the best treatments as they will have the fewest side effects.
- Change Your Toothpaste and Mouthwash – Burning Mouth Syndrome can stem from the types of toothpaste and mouthwash you are using. It is recommended to switch back to plain baking soda without the mouthwash. It is also advised to wash brush dentures with baking soda.
- Stop Smoking Cigarettes – Smoking burns and irritates your tongue and can cause your disruptive and painful symptoms
- Stress Reduction and Relaxation – Relaxation exercises, breathing exercises, massage, hypnosis, yoga and visualization techniques are all wonderful ways to help reduce stress, which could be causing your Burning Mouth Syndrome.
- Stay Hydrated – One of the most important diet changes to alleviate Burning Mouth Syndrome is to drink at least eight glasses of water a day. It helps stimulate saliva production, which will help decrease the pain.
- Avoid Hot Spices – Since Burning Mouth Syndrome can make the mouth and tongue more sensitive to certain foods and spices, pepper, curry, cinnamon and mint should be avoided.
- Avoid Acidic Drinks – Acidity further irritates the mouth and gums.
- Eat more Vitamin B Foods – Eat leafy green vegetables, beets and cantaloupe for folic acid. Salmon, potatoes, chicken are all good sources of B-3, or niacin. Brown rice, soy products, broccoli, oatmeal and whole grains are all great sources of B-6 vitamins.
- Phytoestrogens – Adopt a dietary plan that includes foods that contain phytoestrogens. These plant estrogens bind to estrogen receptors in your body and can alleviate headaches. Soy, tofu, beans, legumes, seaweed, potatoes, apples and carrots are all wonderful sources of phytoestrogens.
- Replenishing Your Diet – Eating more calcium-rich foods, magnesium-rich foods and Vitamin E-foods, like green vegetables, nuts and almonds, are other easily adaptable diet changes to help alleviate symptoms of Burning Mouth Syndrome.
In addition to lifestyle and dietary changes, some medical treatments are available that may help primary BMS. For menopause-related BMS, herbal remedies that help balance the hormone levels in post-menopausal women may be helpful. Certain anti-depressants show some success in treating BMS, however the possible dry mouth side effect of these medications could also cause pain to worsen. A lozenge form of Klonopin, an anti-epileptic medication, is available. Other treatments include alpha-lipoic acid, which is a powerful anti-oxidant; various saliva replacement products; Cognitive Behavioral Therapy; and capsaicin, which is the active ingredient in chili peppers and has shown to have success in relieving neuropathic pain.
- Vitamins - BMS is often caused by deficiencies in iron, zinc, thiamin, folate, riboflavin, Vitamin B1, Vitamin B2, Vitamin B6, niacin and iron. If one cannot get these vitamins, they can eat fresh vegetables and fruits containing Vitamin B and C.
- Black Cohosh One of the most commonly used herbal remedies is Black Cohosh, a perennial plant that is a member of the buttercup family. It provides powerful phytoestrogens that mimic the hormone’s effects and bind to hormone receptors in the uterus and other parts of the body, alleviating hot flashes. Black Cohosh is also known to relieve hot flashes efficiently and is a good alternative to HRT. It is also used effectively for treating PMS, arthritis and lowering blood pressure. Red Clover, Dong Quai, Ginseng, Kava and evening primrose oil can be used as natural therapies, although there are some risks involved. Herbal supplements are not as closely regulated as prescription drugs and the amount of the herbal product, quality and safety may vary between brands.
- Herbal Remedies – The Ayurvedic herb, Triphala, is used for gargling for its cooling effect. Babool, another Ayurvedic herb, will not only make you feel relief from the symptoms of burning, but it reduces inflammation in mouth. Ayurvedic experts also recommend herbs, Kavala and Gandusha, to reduce inflammation in the mouth and burning tongue syndrome.
- Medications – Medications that affect one’s nervous system and controls pain, such as benzodiazepines, are commonly used to treat BMS, as well as anticonvulsants. Doctors may also suggest rinsing one’s mouth with water and capsicum, the active ingredient in hot peppers.
- Hormone Replacement Therapy – Hormone Replacement Therapy – For more severe cases of Burning Mouth Syndrome, women may seek surgical or pharmaceutical treatments, although it is important to keep in mind that there are many studies showing hormone replacement therapy (HRT) increases a woman’s risk of elevated blood pressure, endometrial and breast cancers, strokes, blood clots and gallbladder disease. It is advised to speak with your doctor or healthcare professional regarding the negative side effects before you begin treatment.