Burning mouth syndrome is frustrating for two reasons. The pain is real and can last a long time, but the mouth often looks completely healthy. People with it may see more than one dentist or doctor before they get an answer. This guide explains what the condition is, which other problems can cause similar burning, how a diagnosis is usually reached, and what treatment and self-care options look like. It draws on information from the National Institute of Dental and Craniofacial Research (NIDCR), part of the National Institutes of Health.
What burning mouth syndrome is
NIDCR describes burning mouth syndrome (BMS) as a painful condition, often described as a burning, scalding or tingling feeling in the mouth. It occurs frequently, often every day, for months or longer. Some people feel constant pain all day. For others, pain is relatively low after waking and increases as the day goes on.
The burning can occur anywhere in the mouth. According to NIDCR, it is more common on the tip, sides and top of the tongue, the roof of the mouth and the lips.
Symptoms
The main symptom, NIDCR says, is mouth pain that feels like burning, scalding or tingling. It may also come with a feeling of numbness that comes and goes. Other symptoms can include:
- Dry mouth
- Altered taste, such as a metallic taste
NIDCR notes that BMS pain can last for months or years. It also notes a pattern many people recognize: for many people, the pain is temporarily reduced while eating or drinking.
What causes it
Primary BMS: nerve-related
Experts believe BMS is caused by damage to the nerves in the mouth that control pain and taste, according to NIDCR. The condition is more common in women, especially after menopause.
Other conditions that can cause a burning mouth
Sometimes another oral or medical problem is behind the burning sensation. Finding and treating it can make a big difference. NIDCR lists these possibilities:
- Dry mouth, which can be caused by certain medicines, disorders such as Sjögren’s disease, or treatments such as radiation therapy. See our guide to dry mouth and your teeth.
- Infection in the mouth, such as a yeast infection. Our oral thrush guide covers this.
- Oral habits, such as tongue hyperactivity (increased tongue movements)
- Allergies to dental products, dental materials (usually metals) or foods
- Anxiety, depression and stress
- Acid reflux
- Hormonal changes, such as those from diabetes or thyroid problems
- Certain medicines, such as some that reduce blood pressure
- Nutritional deficiencies, such as low levels of vitamin B or iron
Because the list is long, it helps to bring your full medical history, a list of current medicines and supplements, and notes on any recent dental work or new oral care products to your appointment.
How it is diagnosed
People with BMS often have no visible signs in the mouth during an exam, so diagnosis can take time. NIDCR explains that BMS can be hard to diagnose partly because the burning can occur even when the mouth looks healthy and blood tests are normal. A dentist or doctor will rule out other conditions first.
Start with your dentist
NIDCR recommends talking to your dentist first. A dentist or doctor will review your medical history and examine your mouth to rule out other causes of mouth pain, such as tooth and gum problems, infections or irritation.
Possible tests
NIDCR lists additional tests that may be needed:
- Blood tests to check for certain medical problems
- Oral swab tests
- Allergy tests
- Salivary flow tests
- Imaging tests
Specialist referrals
Your dentist may refer you to a specialist in oral surgery, oral medicine or oral pathology, or to an ear, nose and throat specialist. Our article on dental specialists explains what several of these specialists do. If you have been evaluated and still have no answer, a second opinion can be reasonable.
Treatment options
NIDCR stresses that BMS is complex and that a treatment that works for one person may not work for another. You may need to try different approaches over time. Options it describes include:
- Medicines for pain and dry mouth. A dentist or doctor may prescribe medicines that help control pain and relieve dry mouth.
- Medicines that calm overactive nerves. Some medicines used for anxiety, depression and other neurologic disorders can reduce BMS discomfort by calming overactive nerves.
- Treating an underlying condition. If an oral or medical condition is causing the pain, treating it may help the symptoms go away.
- Changing a medicine. If a medicine is mainly causing the problem, your doctor may switch you to a different one.
- Managing oral habits. Your dentist may help you manage habits such as tongue hyperactivity.
Do not stop or change a prescribed medicine on your own. Talk with the doctor who prescribed it first.
Self-care tips that may ease the burning
Since many people feel better while eating or drinking, NIDCR suggests these comfort measures:
- Sip a cold beverage
- Suck on ice chips
- Chew sugarless gum
NIDCR also recommends avoiding things that can irritate the mouth:
- Tobacco products
- Hot, spicy foods
- Alcoholic beverages
- Mouthwash that contains alcohol
- Products high in acid, such as citrus fruits and juices
Keeping a simple symptom diary can help too. Note when the pain is worst, what you ate or drank, new products you started and your stress level. Patterns can help your care team narrow down causes.
Working with your care team
NIDCR notes that working closely with a dentist or doctor you trust, and sharing your concerns, can help during the diagnostic process. Some practical steps:
- Ask which conditions have already been ruled out and which have not.
- Ask whether any of your medicines or dental materials could be contributing.
- Ask how long to try a treatment before deciding whether it works.
- Ask whether a referral to an oral medicine specialist or another specialist makes sense.
If you need to find a dentist to start this process, you can search for a dentist near you.
Frequently asked questions
Is burning mouth syndrome dangerous?
The NIDCR overview focuses on pain and quality of life rather than on danger. However, other conditions such as infections can cause similar burning, so it is important to get an exam and rule them out.
Why does my mouth look normal if it hurts so much?
NIDCR explains that people with BMS often have no visible signs in the mouth during an exam, and that blood tests may be normal. That is part of why diagnosis can take time.
Who gets burning mouth syndrome?
Anyone can, but NIDCR says it is more common in women, especially after menopause.
Will it go away?
NIDCR says BMS pain can last months or years. When an underlying condition is found and treated, symptoms may go away. Otherwise, treatment aims to manage the pain, and it may take several tries to find what works.
Can my toothpaste or mouthwash make it worse?
Possibly. NIDCR lists allergies to dental products as one possible cause of burning and recommends avoiding mouthwash that contains alcohol. Ask your dentist before switching products.
Sources
By the Dentist Review Editorial Team.
This article is for general information only and is not medical advice. Talk to a licensed dentist about your own situation. See our disclaimer.
Featured image: “Glass of water refracting light” by MarshyBoardwalk, via Wikimedia Commons, licensed CC0. Resized and compressed for the web.
Our guides are written and reviewed by the Dentist Review editorial team. We research each topic using public, authoritative sources such as the CDC, the National Institutes of Health (NIH/NIDCR), the American Dental Association (ADA) and CMS, and we update guides when guidance changes. Guides are for general information only and are not dental or medical advice; please read our disclaimer and learn more about us.