Burning mouth or burning tongue syndrome is a condition where a patient exhibits a burning sensation in the mouth without evidence of any disease present. The symptoms associated with burning mouth syndrome are similar to what a patient can experience with vitamin B deficiency, pernicious anemia, iron deficiency anemia, and chronic atrophic candidiasis. The condition can be difficult to diagnose and treat because of little to no clinical findings.
The list below includes factors that may contribute to the symptoms of burning mouth. In some individuals more that one of these may be contributing to the condition.
- Microorganisms, especially fungi and bacteria
- Dry mouth (xerostomia) associated with Sjogren’s syndrome, anxiety, and medication
- Vitamin and mineral deficiencies. These usually include B vitamin, iron and zinc.
- Iron deficiency and pernicious anemia
- Hormone imbalance, especially postmenopausal hypoestrogenemia
- Neurologic abnormalities such as depression, cancer phobia or other psychogenic problems
- Diabetes mellitus
- Mechanical trauma caused by chronic denture irritation or an oral habit
- Unknown causes, which would include anything that cannot be explained
Burning mouth syndrome usually affects middle-aged woman. Men can be affected but at a later age than women. It is a relatively common condition in adults over 40 years of age. It is rare in children and young adults.
Symptoms of burning and pain can be accompanied by altered taste and dry mouth. Symptoms are usually described by patients as severe, always present, and worsening in the evening. Any region of the mouth may be affected, although the most common site is the tongue. The affected tissue appears normal and similar to the unaffected areas. Burning mouth syndrome provides challenges for the clinician in determining what factors triggered the symptoms, which is necessary to provide effective treatment for the condition.
Treatment of burning mouth syndrome can be difficult. In some cases, it is based on eliminating any factors that may be contributing to the syndrome. If the patient has nutritional deficiencies, replacement therapy will eliminate the problem. However, most individuals will not fall into a category where a cause and solution is clear. Neurologic problems, hormonal changes, or idiopathic disease is very difficult to pinpoint and to treat. Clinicians usually will treat burning mouth syndrome on the basis of a clinical educated guess and previous treatment experience. This should include an empathic approach to treating patients, different medication combinations such as viscous lidocaine, steroids and tricyclic antidepressants. There is no easy solution to treating burning mouth syndrome and unfortunately some individuals may have to accept the disease and learn to live with the problem.