Burning Mouth Syndrome – Treatment, Home Remedy, Menopause, Causes, ICD-10

Key Facts

• Burning mouth syndrome (BMS) is a chronic oral condition characterized by a burning sensation in the mouth
• It can affect the tongue, gums, lips, inside of the cheeks, and the roof of the mouth
• The exact cause of BMS is not always clear, and it may vary from person to person
• The condition is often associated with a range of other symptoms such as dry mouth and altered taste
• BMS is more common in middle-aged and older women, especially postmenopausal women
• Management strategies focus on symptom relief as there is no definitive cure for the condition

What is Burning Mouth Syndrome?

Burning mouth syndrome (BMS) is a medical condition that causes a person to experience a burning sensation in the mouth, which can be moderate to severe. The sensation is often described as similar to scalding or burning, akin to having sipped a very hot beverage. The discomfort may be continuous or intermittent and can last for months or even years. BMS can be distressing and significantly affect a person’s quality of life.

Types of Burning Mouth Syndrome

There are two primary types of burning mouth syndrome:

• Primary Burning Mouth Syndrome: This type has no identifiable medical cause. It is thought to be linked to problems with the nerves that control pain and taste in the mouth.
• Secondary Burning Mouth Syndrome: This type is attributed to an underlying medical condition such as hormonal imbalances, allergies, dry mouth, certain medications, or nutritional deficiencies (such as a lack of vitamin B, iron, or zinc).

Identifying whether BMS is primary or secondary is crucial, as it can impact the approach to management and treatment.

Is Burning Mouth Syndrome More Common in Certain People?

Burning mouth syndrome tends to be more common in middle-aged and older adults, with a higher prevalence among women, especially those who are postmenopausal. While the exact reason for this demographic trend is not entirely clear, hormonal changes are thought to play a role.
Additionally, individuals with certain underlying health conditions such as diabetes, thyroid disorders, or nutritional deficiencies may be more susceptible to developing BMS. Psychological factors such as anxiety, depression, and stress have also been linked to the syndrome and can exacerbate symptoms.

Diagnosis and Causes

Diagnosing burning mouth syndrome can be challenging, as it often involves ruling out other conditions that cause similar symptoms. A healthcare provider or dentist may perform various tests, review medical history, and possibly refer patients to specialists.
The cause of primary BMS is not well understood, but it is believed to involve neuropathic pain – pain that arises due to nerve abnormalities.
Secondary BMS can be due to a variety of factors, including:

• Hormonal changes, particularly a decline in estrogen
• Dry mouth conditions
• Certain medications
• Oral infections such as thrush
• Acid reflux
• Allergic reactions to dental products or foods
• Nutritional deficiencies
• Psychological factors

Treatment and Management

The treatment of burning mouth syndrome is aimed at alleviating symptoms and addressing any underlying causes when they can be identified. For secondary BMS, treating the underlying condition often resolves the symptoms.
Some of the treatment options include:

• Medication Management: Certain medications can be used to relieve pain, including tricyclic antidepressants, anticonvulsants, and mouthwashes with an anesthetic action.
• Saliva Substitutes and Oral Products: For dry mouth, saliva substitutes and products that help keep the mouth moist can be beneficial.
• Nutritional Supplements: If BMS is linked to a deficiency, nutritional supplements may be recommended.
• Behavioral Therapy and Stress Management: Since psychological factors can contribute to BMS, counseling, relaxation techniques, and stress management can be effective components of a treatment plan.
• Lifestyle Modifications: Patients are often advised to avoid substances that can irritate the mouth, such as tobacco, alcohol, and spicy foods.

Managing BMS often requires a multifaceted approach, and it is essential to work closely with a healthcare provider to develop an individualized treatment plan.

What are the Symptoms of Burning Mouth Syndrome?

The primary symptom of Burning Mouth Syndrome (BMS) is a persistent burning sensation in the mouth. This sensation can affect various areas including the tongue, lips, gums, palate, throat, or the entire mouth.
Additional symptoms that may accompany this burning sensation include:

• Dryness or a feeling of dry mouth
• Altered taste sensations, such as a metallic or bitter taste
• Loss of taste
• Increased thirst
• Sensitivity to hot, spicy, or acidic foods
• A tingling or numb sensation in the mouth or on the tip of the tongue
• Redness in the affected areas (though often the mouth appears normal despite the sensation)

What is the Main Cause of Primary Burning Mouth Syndrome?

Primary Burning Mouth Syndrome is thought to be of neuropathic origin, meaning that it is related to nerve problems. While the exact cause is not well understood, it is believed that in primary BMS, there is a dysfunction in the nerves that transmit sensory information in the mouth. There is no identifiable underlying medical condition in primary BMS, and it is often diagnosed when other causes have been ruled out.

What are the Causes of Secondary Burning Mouth Syndrome?

Secondary Burning Mouth Syndrome is linked to an underlying condition or factor.
Some of the causes of secondary BMS include:

• Hormonal Changes: Particularly in postmenopausal women due to a decrease in estrogen levels
• Medications: Certain medications can cause a dry mouth, which can contribute to BMS
• Oral Health Issues: Such as oral thrush, oral lichen planus, or ill-fitting dentures
• Nutritional Deficiencies: Particularly deficiencies in vitamins such as B1, B2, B6, B12, iron, zinc, and folic acid
• Dry Mouth (Xerostomia): Conditions that cause dry mouth, such as Sjogren’s syndrome
• Allergic Reactions: To food, dental products, or materials used in dental work
• Acid Reflux: Stomach acids can cause irritation in the mouth and lead to BMS
• Psychological Factors: Including anxiety, depression, and stress

Are There Certain Medications That Cause Burning Mouth Syndrome?

Yes, certain medications are known to cause oral dryness, which can contribute to Burning Mouth Syndrome. Medications that can have this side effect include:

• Antidepressants
• Antihistamines
• Blood pressure medications
• Diuretics
• Certain medications used for chemotherapy

If someone suspects that their medication may be contributing to symptoms of BMS, it’s important to consult a healthcare provider before making any changes to the medication regimen. A healthcare provider can advise on possible alternatives or adjustments to the medication.

What Vitamin Deficiency Causes Burning Mouth Syndrome?

Burning Mouth Syndrome (BMS) can be linked to nutritional deficiencies, and among these, vitamin deficiencies play a significant role.
The vitamins whose deficiencies are commonly associated with BMS include:

• Vitamin B1 (Thiamine)
• Vitamin B2 (Riboflavin)
• Vitamin B6 (Pyridoxine)
• Vitamin B12 (Cobalamin)
• Folic Acid
• Iron
• Zinc

These deficiencies can contribute to the development of BMS due to their role in nerve function and maintaining the health of the mucous membranes in the mouth.

Diagnosis: How is Burning Mouth Syndrome Diagnosed?

Diagnosing Burning Mouth Syndrome involves a series of steps to rule out other possible causes of the symptoms.
This often includes:

• Medical History Review: The healthcare provider will inquire about the patient’s medical history, medications, and any changes in health
• Oral Examination: The provider will examine the mouth to check for any abnormalities
• Blood Tests: Blood tests may be ordered to check for nutritional deficiencies, infection, or other underlying health conditions
• Salivary Flow Test: To assess if dry mouth is contributing to the symptoms
• Oral Biopsy: In some cases, a small sample of tissue from the oral cavity may be taken to rule out oral diseases
• Allergy Tests: This is to rule out any allergic reactions to foods or dental products
• Medication Review: Reviewing the medications the patient is taking to check if any could be causing the symptoms

How Can I Relieve Burning Mouth Syndrome?

Relief from Burning Mouth Syndrome may involve addressing the underlying causes as well as managing symptoms.
Some methods for relief include:

• Changing Medications: If medication is suspected to be the cause, a healthcare provider may recommend changing or adjusting medications
• Nutritional Supplements: If a vitamin or mineral deficiency is diagnosed, taking supplements as prescribed by a healthcare provider
• Managing Dry Mouth: Sipping water throughout the day, using a saliva substitute, or taking medication that helps increase saliva production
• Oral Rinses: Using specially formulated oral rinses or a mild baking soda-water solution (1/4 teaspoon of baking soda in 1 cup of water) to relieve the mouth’s burning sensation
• Avoiding Irritants: Avoiding hot, spicy, or acidic foods and beverages that can irritate the mouth
• Proper Oral Care: Practicing good oral hygiene by regularly brushing and flossing
• Stress Management: Engaging in stress-reducing activities such as exercise, meditation, or hobbies

It is important to consult a healthcare provider for a proper diagnosis and personalized treatment plan for Burning Mouth Syndrome.

How is Burning Mouth Syndrome Treated?

Treatment for Burning Mouth Syndrome (BMS) depends on the underlying causes. Once an evaluation is done and the potential causes identified, a healthcare provider may recommend a combination of the following treatments:

• Addressing Nutritional Deficiencies: If BMS is due to a deficiency in vitamins or minerals, supplements may be prescribed.
• Medications: Certain medications may be prescribed to relieve the symptoms of BMS, including antidepressants, anticonvulsants, or medications that block nerve pain.
• Oral Rinses and Artificial Saliva: These can help to soothe the mouth if BMS is associated with dry mouth. A mild baking soda and water solution can also be effective.
• Behavioral Therapy: In some cases, cognitive behavioral therapy may be suggested to manage stress, depression, or anxiety, which can exacerbate BMS.
• Pain Management: Over-the-counter pain relievers and mouth gels can sometimes alleviate discomfort.
• Changing Medications: If BMS is linked to a medication you are currently taking, your healthcare provider may adjust the dosage or switch you to a different medication.

How Can I Prevent Burning Mouth Syndrome?

While not all cases of Burning Mouth Syndrome are preventable, the following steps may help reduce the risk or alleviate the symptoms:

• Maintain Good Oral Hygiene: Regularly brush and floss, and avoid using mouthwashes that contain alcohol
• Avoid Irritants: Stay away from hot, spicy, or acidic foods and beverages, as well as tobacco and alcohol
• Stay Hydrated: Drink plenty of water throughout the day
• Manage Stress: Engage in stress-reducing techniques such as exercise, meditation, or hobbies
• Regular Dental Check-Ups: Regular visits to the dentist can help in early detection and management of oral health issues
• Use a Humidifier: Keeping the air moist, especially during sleep, can help alleviate dry mouth

What is the Outlook for Burning Mouth Syndrome?

The outlook for Burning Mouth Syndrome varies depending on the underlying cause. If a specific cause is identified and can be treated, such as a nutritional deficiency, then the outlook is generally good. However, in cases where no specific cause is found, managing the symptoms can be more challenging and the condition may be chronic.

How Long Does it Take for Burning Mouth Syndrome to Go Away?

The duration of Burning Mouth Syndrome can vary widely. For some individuals, the symptoms may diminish or resolve over time, especially if an underlying cause is identified and treated. However, in other cases, BMS can be a chronic condition that persists for months or even years. Management and treatment are often focused on reducing discomfort and improving quality of life.

How long could I have BMS for?

Burning Mouth Syndrome (BMS) can vary in duration among different individuals. For some, it might be a short-term issue, but for others, it can be a chronic condition lasting for several months to years. The intensity can also vary, with some experiencing constant pain while others have intermittent symptoms.

Are there any medical conditions that can cause it?

There are several medical conditions that are known to be associated with Burning Mouth Syndrome, including:

• Hormonal Changes: Menopausal women are often affected, suggesting a link between hormonal changes and BMS
• Nutritional Deficiencies: Deficiencies in vitamins and minerals, particularly vitamin B, iron, and zinc, can be linked to BMS
• Dry Mouth (Xerostomia): Conditions that cause dry mouth, such as Sjogren’s Syndrome, can contribute to the burning sensation
• Oral Candidiasis: A fungal infection in the mouth can sometimes cause symptoms similar to BMS
• Diabetes: Diabetic patients frequently experience oral symptoms including BMS
• Medications: Certain medications, especially those that cause dry mouth as a side effect, can contribute to BMS
• Allergic Reactions: Allergies to dental products, food, or dental materials can cause a burning sensation in the mouth
• Gastroesophageal Reflux Disease (GERD): Acid reflux can cause irritation and burning in the mouth and throat
• Anxiety and Depression: There is an association between psychological disorders and BMS
• Neuropathy: Damage to nerves that control taste and pain in the tongue can also contribute to BMS

Because of the variety of potential causes and contributing factors, managing Burning Mouth Syndrome often requires addressing underlying or associated conditions. It is important to consult with a healthcare provider, typically a dentist or doctor, for an evaluation and appropriate management of the condition.

Questions to ask your doctor

When you have an appointment with your doctor regarding Burning Mouth Syndrome or any other health concern, it’s important to ask questions that will help you understand your condition better and make informed decisions about your treatment. Here are some questions you may want to ask:

• What is the likely cause of my burning mouth symptoms?
• Are there any tests that I need to undergo to confirm the diagnosis?
• Could my symptoms be related to medications I am currently taking?
• Are there underlying health issues that could be contributing to my symptoms?
• What treatment options are available for Burning Mouth Syndrome?
• Are there any side effects of the recommended treatments?
• What can I do at home to alleviate the symptoms?
• Is there a possibility that nutritional deficiencies are contributing to my condition?
• Should I take any supplements?
• How can I manage dry mouth, if that’s contributing to my symptoms?
• Is this condition temporary or chronic? What can I expect in terms of progression or resolution?
• Should I avoid certain foods or drinks that can aggravate my symptoms?
• Are there any over-the-counter products that you would recommend for symptom relief?
• Is stress or anxiety a contributing factor, and if so, what can I do to manage it?
• Will I need to see a specialist for further evaluation or treatment?
• How often should I follow up with you regarding this condition?

Remember that it’s important to communicate openly with your doctor and to feel comfortable asking for clarification if there’s something you don’t understand. It’s also a good idea to take notes or bring someone with you to help remember the information provided during the appointment.

Is Burning Mouth Syndrome Contagious?

No, Burning Mouth Syndrome is not contagious. It is a condition characterized by chronic burning sensation in the mouth, and it’s primarily associated with neuropathic issues, underlying health conditions, or nutritional deficiencies. It is not caused by an infectious agent such as bacteria or viruses, so it cannot be spread from person to person.

Burning Mouth Syndrome ICD-10

The ICD-10 code for Burning Mouth Syndrome is K14.6. ICD-10, which stands for the International Classification of Diseases, 10th Edition, is a system used worldwide for coding various medical conditions.

Bottom line

Burning mouth syndrome is a complex and often frustrating condition for those who experience it. Understanding the types of BMS, the populations it commonly affects, and the various underlying causes can help in managing this condition more effectively. Treatment requires a patient-centric approach, often involving a combination of medications, lifestyle changes, and psychological support. Consultation with a healthcare provider is essential for proper diagnosis and management.

This article is complete and was published on June 28, 2023, and last updated on August 25, 2023.