Burning Mouth Syndrome: Causes, Symptoms, Treatment, and Cost

Burning Mouth Syndrome (BMS) is a relatively rare and poorly understood condition that causes a persistent burning sensation in the mouth, tongue, lips, gums, throat or entire oral cavity, with no apparent visible abnormalities or lesions. It is possible for the pain to be modest to severe and to linger for several days, weeks, or even years.

BMS is more common in women than men and is most commonly found in people over the age of 60, although it can affect people of any age. The condition can be classified into two types: primary BMS, which has no identifiable cause, and secondary BMS, which is caused by an underlying medical condition or medication.

The symptoms of BMS can vary from person to person but typically include a persistent burning or tingling sensation in the mouth that can be accompanied by dry mouth, a metallic or bitter taste, and a loss of taste sensation. The symptoms may worsen throughout the day and maybe more intense when eating or drinking.

Diagnosing Burning Mouth Syndrome (BMS) can be challenging, as there are no specific tests or visible signs to confirm the presence of the condition. However, there are specific criteria and diagnostic procedures that doctors and dentists may use to determine whether a patient is experiencing BMS.

One of the primary diagnostic criteria for BMS is the presence of a persistent burning sensation in the mouth, tongue, lips, gums, throat or entire oral cavity, with no visible abnormalities or lesions. Patients may also report other symptoms such as dry mouth, changes in taste sensation, or a metallic or bitter taste in the mouth.

To help diagnose BMS, a doctor or dentist may perform a physical examination of the mouth to rule out other conditions that may cause similar symptoms, such as oral thrush, vitamin deficiencies, or a reaction to dental materials. Blood testing may also be used to look for underlying medical diseases including thyroid problems or diabetes that could be a factor in BMS.

In some cases, a biopsy of the mouth tissue may be performed to rule out other conditions or to confirm the presence of BMS. However, biopsies are typically reserved for cases where other diagnostic tests have been inconclusive, as they can be painful and may not always provide definitive results.

To further aid in the diagnosis of BMS, doctors, and dentists may also use questionnaires or surveys to assess the patient's symptoms and quality of life. These surveys may help identify any underlying psychological factors contributing to the patient's symptoms, such as stress, anxiety, or depression.

Burning Mouth Syndrome (BMS) can be classified into two types: primary BMS and secondary BMS. Understanding the different types of BMS can help doctors and dentists to develop an appropriate treatment plan and improve the patient's quality of life.

Primary BMS is the more common type of BMS, and it is characterized by a persistent burning sensation in the mouth with no apparent visible abnormalities or lesions. Primary BMS has an elusive specific cause, however, it is thought to be a result of harm to or dysfunction of the nerves in the mouth that regulate taste and pain. The emergence of primary BMS may also be influenced by psychological factors including stress, anxiety, or depression.

Secondary BMS, Contrarily, secondary BMS is brought on by an underlying illness or medication. Medical conditions that may contribute to secondary BMS include dry mouth, oral thrush, acid reflux, and nutritional deficiencies. Medication used to manage high blood pressure, depression, anxiety, and allergies are just a few of the drugs that may result in secondary BMS.

There is no known reason for the complex illness known as burning mouth syndrome (BMS). Nonetheless, a number of factors may have a role in the emergence of BMS. These factors can be divided into the following categories;

• Nerve Damage or Dysfunction: Nerve damage or dysfunction in the mouth can lead to altered taste and pain sensations, which may cause the burning sensation associated with BMS. According to some experts, BMS may be brought on by harm to or dysfunction of the nerves that regulate taste and pain perception in the mouth.
• Hormonal Changes: Hormonal changes, particularly in women, have been linked to the development of BMS. BMS may be more prone to develop in women going through menopause or who have hormonal abnormalities.
• Nutritional Deficiencies: Deficiencies in certain nutrients, such as iron, zinc, and vitamin B12, may contribute to the development of BMS. These nutrients are critical for the healthy operation of the nerves in the mouth and may influence the sensation of taste and pain.
• Medications: Several drugs, including those for high blood pressure, depression, and anxiety, have been associated with the emergence of BMS. Although the precise mechanism by which these drugs elicit BMS is unknown, it is thought to be connected to altered taste and pain perceptions.
• Psychological Factors: BMS may occur as a result of stress, anxiety, or sadness. These factors may alter the way that the brain processes pain signals, leading to the burning sensation associated with BMS.

Some people may experience other symptoms in addition to the burning sensation. The symptoms can be divided into the following categories;

Oral Symptoms

The most common symptom of BMS is a persistent burning sensation in the mouth that may affect the tongue, lips, gums, or entire mouth. The burning sensation may be described as a scalding, tingling, or numbness. Moreover, some persons may have dry mouth or a metallic taste.

Psychological Symptoms

BMS can cause psychological symptoms, such as anxiety and depression. These symptoms may be a result of the discomfort and pain associated with the condition, as well as the difficulty in diagnosing and treating BMS.

Physical Symptoms

In addition to the oral and psychological symptoms, some people with BMS may experience physical symptoms, such as headaches, muscle pain, and joint pain. These symptoms may be related to the underlying causes of BMS, such as hormonal imbalances or nutritional deficiencies.

Burning Mouth Syndrome (BMS) is a condition that can affect anyone, but there are certain risk factors that may increase the likelihood of developing BMS. These risk elements may consist of;

• Age: Middle-aged and older persons are more likely to have BMS.
• Gender: Women are more likely to have BMS than men.
• Medical Conditions: Underlying medical conditions, such as dry mouth, diabetes, and thyroid problems, may increase the risk of developing BMS.
• Medications: BMS has been connected to the use of some drugs, including those for high blood pressure, depression, and anxiety.
• Nutritional Deficiencies: Deficiencies in certain nutrients, such as iron, zinc, and vitamin B12, may contribute to the development of BMS.
• Allergies: Allergic reactions to certain foods or dental products may increase the risk of developing BMS.
• Psychological Factors: BMS may occur as a result of stress, anxiety, or depression.

Burning Mouth Syndrome (BMS) can be a challenging condition to treat, and prevention strategies are not well-defined. However, there are a number of actions that could assist manage the symptoms of BMS or lower the risk of acquiring it.

The following are some Do's and Don'ts that may help prevent BMS;

• Avoid coffee and alcohol, which can promote dehydration, and drink lots of water to stay hydrated
• Have a balanced diet full of foods high in vitamins and minerals like iron, zinc, and vitamin B12
• By frequently flossing and brushing your teeth, as well as seeing the dentist for regular checkups, maintain proper oral hygiene
• Manage stress levels through relaxation techniques, such as deep breathing or meditation

• Consume tobacco products, which can cause tongue irritation and up your risk of getting BMS
• Consume spicy or acidic foods, which may irritate the mouth and trigger BMS symptoms
• Use mouthwashes or toothpaste that contain alcohol or strong flavorings, which can irritate the mouth and trigger BMS symptoms
• Avoid any discomfort or soreness in the mouth because it can indicate a medical problem that has to be treated.

Burning Mouth Syndrome (BMS) can be a challenging condition to diagnose, as there is no specific test or set of criteria that definitively diagnose BMS. BMS is normally diagnosed based on the patient's symptoms, medical history, and results of a physical examination. To exclude other illnesses that could manifest similarly symptomatic situations, more tests may be required.

The following are some common diagnostic methods used to diagnose BMS;

• Medical History and Physical Examination: The doctor will review the individual's medical history and ask questions about their symptoms and any medications they may be taking. A physical examination of the mouth and tongue may also be performed to look for signs of oral inflammation or other abnormalities.
• Blood Tests: Blood tests may be ordered to check for underlying medical conditions that may cause similar symptoms, such as nutritional deficiencies or hormonal imbalances.
• Allergy Testing: Allergy testing may be carried out to identify the allergen if it is thought that an allergy is the root cause of BMS.
• Salivary Testing: Salivary testing may be performed to check for a decrease in saliva production, which may be a contributing factor to BMS.
• Biopsy: Rarely, a biopsy of the oral tissue may be done to rule out other illnesses that could produce same symptoms.

Burning Mouth Syndrome (BMS), which is typically not harmful or life-threatening, can be extremely painful and interfere with daily life. In some cases, it may lead to complications such as;

• Anxiety or depression: Chronic pain and discomfort can cause anxiety, depression, and other mood disorders.
• Insomnia: Pain and discomfort may make it difficult to sleep, leading to insomnia or other sleep disorders.
• Nutritional deficiencies: BMS may cause difficulty eating or drinking, leading to nutritional deficiencies over time.
• Mouth infections: The constant irritation and inflammation in the mouth may increase the risk of infections.

While there is no cure for Burning Mouth Syndrome (BMS), there are a number of home remedies that can help manage symptoms. Some effective home remedies for BMS include;

• Drinking cool or cold liquids to soothe the mouth
• Using saltwater or water and baking soda to rinse your mouth can help to relieve irritation
• Avoiding spicy or acidic foods that can trigger BMS symptoms
• To prevent future mouth irritation, wash your teeth gently and with a soft-bristled toothbrush
• Using coconut oil or petroleum jelly to the lips and mouth to soothe and hydrate.

While there is no specific diet that is recommended for individuals with Burning Mouth Syndrome (BMS), there are some foods that may help manage symptoms. Some foods that may be helpful include;

• Soft, bland foods like oatmeal, mashed potatoes, and cooked veggies are a few examples of foods that could be beneficial
• Cold or cool foods, such as yogurt or ice cream, which may help soothe the mouth
• Foods rich in vitamin B12, iron, and zinc, which may help alleviate nutritional deficiencies that can contribute to BMS.

Certain foods may exacerbate the symptoms of Burning Mouth Syndrome (BMS) and should be avoided. Some common foods that may trigger BMS symptoms include;

• Spicy or acidic foods such as hot sauce, citrus fruits, and tomatoes
• Foods and beverages with a high temperature, such as hot coffee or tea
• Alcohol and tobacco products, which can irritate the mouth and increase the risk of developing BMS

Although there is no known treatment for BMS, there are a number of treatments that can assist control symptoms and enhance quality of life. Treatment plans for BMS may vary depending on the individual's specific symptoms, underlying causes, and medical history. Here are some common treatment options for BMS;

Medications

Certain medications may be prescribed to manage symptoms of BMS. These may include:

• Antidepressants: Tricyclic antidepressants or selective serotonin reuptake inhibitors (SSRIs) may be prescribed to manage pain, discomfort, and mood disorders associated with BMS.
• Anticonvulsants: Medications such as gabapentin or clonazepam may be prescribed to help manage neuropathic pain associated with BMS.
• Nutritional supplements: Nutritional deficiencies may contribute to BMS symptoms. Supplements containing vitamin B12, iron, and zinc may be recommended to alleviate these deficiencies and manage symptoms.
• Oral rinses: Oral rinses containing lidocaine or other anesthetics may be prescribed to help manage oral pain and discomfort.Hormone replacement therapy
• BMS has been associated with hormonal abnormalities, especially in females. To help women with hormonal abnormalities manage their symptoms, hormone replacement treatment may be suggested.Cognitive-behavioral therapy
• Anxiety, depression, and other mood disorders can result from chronic pain. To treat these problems and enhance quality of life, cognitive-behavioral therapy (CBT) may be suggested.Saliva replacement therapy
• BMS may reduce salivation, which could result in dry mouth and other problems. Saliva replacement therapy, including artificial saliva products or prescription medications that stimulate saliva production, may be recommended.

It is crucial to speak with a healthcare provider if you are suffering from Burning Mouth Syndrome (BMS) symptoms. Your primary care physician may refer you to a specialist, such as an ear, nose, and throat (ENT) doctor or a dentist who specializes in oral medicine. In some cases, a neurologist or psychiatrist may also be consulted to help manage symptoms such as anxiety or depression.

There is no one 'best' medication for treating Burning Mouth Syndrome (BMS), as the most effective treatment may vary from person to person depending on the specific symptoms and underlying causes of BMS. Some medications that may be used to manage BMS symptoms include;

• Tricyclic antidepressants: These medications, such as amitriptyline, nortriptyline, and imipramine, can help relieve pain and discomfort associated with BMS.
• Anticonvulsants: Medications such as gabapentin or clonazepam can help manage neuropathic pain associated with BMS.
• Benzodiazepines: These medications can help reduce anxiety and improve sleep quality, which can be particularly helpful for individuals experiencing BMS-related anxiety or depression.
• Topical anesthetics: Oral rinses or gels containing lidocaine or other anesthetics can help relieve pain and discomfort associated with BMS.

The length of time it takes to recover from Burning Mouth Syndrome (BMS) can vary from person to person, and in some cases, symptoms may persist for years. There is no cure for BMS, and treatment plans are typically aimed at managing symptoms and improving quality of life. Some individuals may experience relief from symptoms within weeks or months of beginning treatment, while others may require ongoing management of symptoms over a longer period of time.

The results of treatment for Burning Mouth Syndrome (BMS) are not always permanent, as there is no known cure for this condition. However, with proper management of symptoms and identification and treatment of underlying causes, many individuals are able to experience significant relief from symptoms and improved quality of life. It's crucial to consult a healthcare provider to create a specialized treatment strategy that takes into account your unique set of symptoms and medical background.

Individuals experiencing symptoms of Burning Mouth Syndrome (BMS) are generally eligible for treatment, regardless of age, gender, or other demographic factors. It is important to work with a healthcare professional to determine the most appropriate treatment plan based on your specific symptoms and medical history.

There are few individuals who may not be eligible for treatment for Burning Mouth Syndrome (BMS), such as individuals with certain medical conditions or who are taking certain medications. It is important to discuss your medical history and any medications you are taking with your healthcare professional to determine the most appropriate treatment options for your specific situation.

After receiving treatment for burning mouth syndrome, it is important to follow post-treatment guidelines to ensure the best possible outcome. Here are some post-treatment guidelines for burning mouth syndrome;

• Follow the treatment plan prescribed by your doctor carefully
• Take all medications as directed and for the full course of treatment
• Attend all follow-up appointments with your doctor
• By brushing your teeth twice each day and flossing every day, you may maintain proper oral hygiene
• Avoid acidic or spicy foods, alcohol, and tobacco, as well as other foods and beverages that could irritate your mouth
• Drink plenty of water to stay hydrated
• Avoid stress as much as possible, as stress can exacerbate burning mouth syndrome
• Get enough rest and maintain a healthy diet to support your overall health

Following these post-treatment guidelines can help to reduce the risk of recurrence and support a healthy recovery from burning mouth syndrome.

The price of Burning Mouth Syndrome treatments in India can vary depending on the type of treatment needed, the severity of the condition, and the location of the medical facility. Typically, treatment for BMS may include medication, oral rinses, or psychological counseling, and the cost may also vary based on the specific drugs or treatments used.

It is best to consult with a healthcare professional to get a better idea of the expected cost for BMS treatment. Additionally, some insurance plans may cover the cost of BMS treatment, so it is recommended to check with your insurance provider to see if the treatment is covered.

Overall, the cost of BMS treatment in India can range from a few hundred rupees to several thousand rupees, depending on the treatment approach and the individual's specific needs.

Burning mouth syndrome can be a challenging condition to treat, and some treatments may have side effects. Here are some of the potential side effects of burning mouth syndrome treatments;

Medications: Certain medications used to treat burning mouth syndrome may have side effects such as;

• Dry mouth
• Drowsiness
• Dizziness
• Constipation

• Mouth rinses: Some mouth rinses used to relieve symptoms of burning mouth syndrome may cause stinging or irritation of the mouth.
• Psychological therapies: Psychological therapies such as cognitive behavioral therapy may cause temporary discomfort as you work through the therapy.
• Oral appliances: Oral appliances such as dental guards or splints may cause jaw discomfort or pain, especially in the beginning of their use.

Burning mouth syndrome and acid reflux are two separate conditions, although they can both cause a burning sensation in the mouth. When stomach acid runs back up into the esophagus, it causes irritation and discomfort. This condition is known as acid reflux. In contrast, burning mouth syndrome is a condition that causes an unidentified burning feeling in the mouth.

The outlook for burning mouth syndrome varies depending on the underlying cause of the condition and the effectiveness of treatment. The condition could become better on its own or with therapy in some circumstances. Some, however, may experience burning mouth syndrome as a chronic illness that needs continuing care to keep symptoms under control.