Burning Mouth Syndrome – Diagnosis and Treatment

ByJanis Updated

Diagnosis

Doctors diagnose burning mouth syndrome (BMS) by looking at several factors because no single laboratory test or scan confirms it. They rule out other possible causes before making a BMS diagnosis.

Doctors consider the patient’s symptoms of burning pain or discomfort in the mouth, tongue, or lips, even when the oral mucosa looks normal.

Key Steps in Diagnosis:

  1. Review of Personal and Medical Information: Doctors gather details about health history, current medications, and any existing chronic pain issues.
  2. Oral Evaluation: Dentists check the oral cavity and mucous membrane for visible signs, including infections or injuries.
  3. Symptom Discussion: Patients describe their oral burning, pain intensity, and any patterns they notice.
  4. Lifestyle and Hygiene Habits: Doctors collect information about daily habits, such as mouth care routines and exposure to possible triggers.

Common Tests and Examinations:

Test Type Purpose/intended outcome
Blood Tests Check blood count, blood sugar, thyroid, nutrition, and immune function.
Oral Culture/Biopsy Detect infections or cellular changes by tissue sampling.
Allergy Testing Identify reactions to foods, additives, or dental products.
Saliva Flow Tests Measure salivary biomarkers and check for dry mouth symptoms.
Gastric Reflux Tests Find out if acid reflux causes oral burning pain.
Imaging Tests (CT/MRI) Rule out other medical issues within the head or neck.
Medication Review/Adjustment Determine if prescribed drugs cause or worsen symptoms.
Mental Health Assessment Screen for anxiety, depression, or emotional issues linked to oral discomfort.

Sometimes, doctors suggest temporarily changing or stopping a medication if they think it may be linked to oral discomfort. Medical supervision is needed for this step due to possible risks.

Doctors also use findings from systematic reviews or meta-analysis studies, which provide information on chronic pain patterns and the role of nerves in oral pain.

These detailed methods help health professionals work toward an accurate diagnosis, even without clear physical signs in the oral mucosa.

Treatment

For people with primary burning mouth discomfort, there is no single solution or guaranteed cure. Treatment focuses on relieving pain and managing nerve-related symptoms.

Doctors often use a trial-and-error process to find what works best. Strategies include:

  • Moisturizers for Dryness: Saliva substitutes help keep the mouth moist.
  • Numbing Agents: Special mouth rinses or lidocaine can numb nerve endings and ease pain.
  • Capsaicin: This compound from chili peppers is sometimes used topically for its effect on nerves.
  • Antioxidants and Supplements: Alpha-lipoic acid and zinc may help reduce nerve pain.
  • Medications:
    • Anticonvulsants can address neuropathic pain.
    • Certain antidepressants and some antipsychotics may help control pain.
  • Other Methods:
    • Low-level laser therapy (LLLT) is being explored for reducing oral pain.
    • Cognitive behavioral therapy helps people cope with anxiety, depression, or stress that can worsen symptoms.

This condition often affects postmenopausal women and may relate to hormonal changes.

Approaches for Treating Related Burning Mouth Conditions

Secondary types of burning mouth issues connect to specific health conditions. Addressing these underlying causes is important.

Approaches include:

  • Nutritional Support: Correcting deficiencies in vitamins like B12, zinc, or iron can help when linked to burning symptoms.
  • Disease Management: Treating oral infections, controlling hypertension, or addressing hypothyroidism can reduce oral discomfort.
  • Addressing Related Conditions: Managing autoimmune diseases or oral lichen planus helps relieve oral burning sensations.

The main goal is to find and treat any health problem causing the mouth pain.

Ways to Manage Symptoms at Home

People can take several steps at home to lessen burning or discomfort in the mouth. Staying hydrated with water or sucking on ice chips soothes dry mouth.

Using sugar-free gum encourages saliva flow, which can help with taste changes. Limiting acidic, spicy, or hot foods may reduce irritation.

A quick reference table:

Problem What to Do
Dry mouth (xerostomia) Drink water, use ice
Low saliva Sugar-free gum
Taste changes Avoid irritants

Avoiding tobacco, alcohol, cinnamon, and mint can protect the mouth’s lining and salivary composition. Using gentle toothpaste and practicing relaxation to lower stress can support better mouth comfort.

Ways to Manage and Find Support

Living with burning mouth syndrome can affect emotional well-being and daily life. Relaxation methods like yoga or deep breathing help reduce stress.

Spending time on hobbies or enjoyable activities can distract from pain and ease anxiety. Staying connected with family and friends offers emotional support.

Joining groups for chronic pain provides a sense of understanding and community. Good sleep habits, such as keeping a regular schedule, support mental health.

If stress or sadness gets worse, talking to a mental health professional can provide helpful coping tools.

Getting Ready for Your Visit

Steps to Take Before Your Appointment

Getting organized before seeing a health care provider about mouth discomfort can help. Make a list of all symptoms, even those that may not seem related.

Note when symptoms started and any recent changes in health or stress. Write down all medicines you take, including vitamins and herbs.

Include both prescription and non-prescription items with their doses. This helps avoid interactions or reveals possible causes of symptoms.

Gather any dental or medical records related to ongoing issues, such as recent tests or past diagnoses. Having these documents ready saves time during the visit.

Ask the doctor’s office if any special preparations are needed before the appointment. Some providers may ask patients not to eat or drink before certain tests.

Consider bringing someone for support. A family member or friend can help remember details and provide emotional support.

Prepare a list of questions. Some suggestions:

  • What could be the main cause of these symptoms?
  • Are there other possible reasons for this discomfort?
  • What tests might be needed?
  • What treatment options are available?
  • Will these symptoms go away or are they likely to last?
  • Should a specialist be consulted?
  • Are there limits or restrictions to follow?
  • Are there more affordable treatment alternatives?

It helps to use a checklist, like the one below, to stay organized:

Task Completed (✔/✗)
List symptoms  
List medicines and supplements  
Gather records and test results  
Ask about pre-appointment steps  
Prepare questions  
Bring support person  

Add any other questions or concerns to the list.

What Providers Will Want to Know

Health care professionals will likely ask several questions during the visit to better understand the problem.

Typical questions may include:

  • When did the symptoms begin?

  • How often do they occur?

  • Are the symptoms mild or very uncomfortable?

  • Does anything improve or worsen the problem?

  • Is there a history of tobacco or alcohol use?

  • Are acidic or spicy foods often eaten?

  • Are dentures worn regularly?

Providers may ask more questions based on the individual case. You should be honest and give as many details as possible so the provider can diagnose and treat the problem accurately.


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Health Writer

Janis's areas of expertise include nutrition, exercise, stress management, and mental health. She is passionate about educating and empowering people to take control of their health and make positive changes that can last a lifetime. Janis believes that small, sustainable changes are the key to long-term success, and she works with her clients to develop personalized plans that fit their individual needs and lifestyles.