Burning Mouth Syndrome (BMS) is a chronic pain condition characterized by a persistent, uncomfortable sensation in the mouth without any apparent physical damage or oral lesions. This discomfort is often described as a burning or scalding feeling that can last for months or even years. BMS can significantly impact a person’s quality of life due to the continuous nature of the pain. It is a neurological challenge affecting an estimated 2% of the population, with post-menopausal women being diagnosed more frequently than men.
Addressing the Contagion Question
Burning Mouth Syndrome is a non-communicable health condition and is not contagious. The discomfort results from internal, physiological processes, not an infection that can be passed from one person to another. This means it cannot be transmitted through contact, saliva, or airborne particles, nor is it caused by a virus or bacteria.
The syndrome is considered a type of neuropathic pain, originating from abnormal nerve function rather than an external source. Understanding that BMS is a disorder of sensation can help relieve anxiety about transmissibility. The condition is entirely contained within the individual, and there is no risk of spreading it to family or friends.
Defining Burning Mouth Syndrome
The sensation associated with BMS is most commonly described as a burning, scalding, or tingling feeling inside the mouth. This pain often affects the tip and sides of the tongue, but it can also be felt on the lips, the roof of the mouth, or the gums. The degree of discomfort can vary, sometimes starting mildly in the morning and becoming worse as the day progresses.
Patients frequently report additional symptoms alongside the burning, such as a persistent dry mouth sensation (xerostomia), even when saliva production is adequate. Altered taste (dysgeusia) is also common, often manifesting as a bitter or metallic flavor. The defining clinical feature of BMS is the absence of any visible mucosal changes, lesions, or other oral abnormalities that would explain the pain.
Underlying Causes and Triggers
BMS is broadly categorized into two types based on its origin: Primary and Secondary. Primary BMS, also known as idiopathic, occurs when no underlying medical or dental cause can be identified. It is thought to be related to damage or dysfunction in the small nerves that control taste and pain perception in the mouth, making it a chronic neuropathic pain disorder.
Secondary BMS is caused by an identifiable underlying condition, and treating that condition often resolves the burning sensation. Local factors contributing to secondary BMS include dry mouth stemming from certain medications or systemic diseases like Sjögren’s syndrome. Oral infections, such as candidiasis, or chronic irritation from ill-fitting dentures may also trigger symptoms.
Systemic diseases frequently linked to secondary BMS include diabetes and thyroid dysfunction, which affect nerve health and sensation. Nutritional deficiencies are another trigger, particularly low levels of B vitamins, iron, or zinc, which are necessary for healthy nerve and tissue function. Gastroesophageal Reflux Disease (GERD) can also cause symptoms if stomach acid irritates the oral tissues.
Current Treatment Approaches
The approach to managing BMS depends on whether the case is classified as primary or secondary. For secondary BMS, treatment focuses on correcting the underlying cause, such as prescribing antifungal medication or supplementing for a diagnosed vitamin deficiency. If a medication is suspected of causing dry mouth or burning, a healthcare provider may adjust the dosage or switch to an alternative drug.
Managing primary BMS often involves medications aimed at calming the overactive pain nerves. Systemic medications frequently used include certain anticonvulsants, such as clonazepam, which is often prescribed in small doses to be dissolved in the mouth for localized effect. Tricyclic antidepressants or other nerve pain medications may also be used to modulate pain signals.
Topical treatments are utilized to provide direct relief, with options including lidocaine rinses or capsaicin. Capsaicin, a compound derived from chili peppers, works by desensitizing pain receptors.
Lifestyle modifications can further aid in symptom management, such as avoiding irritants like acidic foods, alcohol-based mouthwashes, and spicy items. Cognitive behavioral therapy is sometimes recommended to help patients develop coping strategies for the chronic pain experience.