The sensation of a burning tongue, medically known as glossopyrosis or glossodynia, is a common symptom that can be temporary or chronic. People often describe the feeling as a scald, similar to drinking overly hot coffee, but it occurs without any obvious injury. This discomfort is not a single disease but a complex symptom with underlying causes that can be local, systemic, or neuropathic. Medical professionals must investigate and exclude various potential triggers before making a definitive diagnosis.
Immediate Triggers: Physical and Chemical Irritants
The most straightforward causes of a burning tongue are direct, external irritants that cause immediate physical or chemical damage to the oral mucosa. Consuming food or beverages that are too hot directly activates temperature-sensitive pain receptors in the mouth. This thermal injury creates a lingering sensation of being scalded, a temporary inflammation that usually resolves on its own.
Spicy foods, particularly those containing capsaicin from chili peppers, cause a chemical burn by activating the transient receptor potential vanilloid 1 (TRPV1) receptor. This receptor effectively tricks the nerve endings into sensing a painful burning temperature. Highly acidic foods, such as citrus fruits, tomatoes, or vinegar, can also cause direct irritation and erosion of the delicate mucosal lining. This chemical breakdown exposes underlying nerve endings, resulting in a stinging or burning sensation.
Systemic Causes: Deficiencies and Digestive Issues
A persistent burning sensation often points toward internal health issues, especially those affecting cell health and the digestive system. Nutritional deficiencies, particularly involving B vitamins like B12 and folate, and the mineral iron, can compromise the health of the tongue. These nutrients are necessary for the rapid turnover of epithelial cells that line the tongue and for maintaining healthy nerve function.
When deficient, the lingual papillae on the tongue’s surface can atrophy, leading to a smooth, red appearance known as atrophic glossitis. A lack of Vitamin B12 can also lead to nerve damage, or neuropathy, felt as a burning or tingling sensation. Addressing these deficiencies through targeted supplementation can often resolve the glossodynia.
Gastroesophageal Reflux Disease (GERD) or its silent form, Laryngopharyngeal Reflux (LPR), is another common systemic factor. This occurs when stomach contents, including corrosive acid and bile salts, backflow up the esophagus and reach the back of the throat and mouth. The oral and pharyngeal tissues are not equipped with the same protective lining as the esophagus, leading to chemical irritation and a chronic burning sensation. This discomfort is often worse after meals or when lying down.
Oral infections, such as thrush (Candida albicans), can also cause burning by disrupting the natural microbial balance. This fungal overgrowth causes a generalized inflammatory response that manifests as a painful burn. A lack of sufficient saliva (xerostomia or dry mouth) reduces the protective barrier of the oral mucosa, leaving the tongue vulnerable to irritants and infections like thrush.
Contact Sensitivities and Allergic Responses
When the burning sensation is specifically triggered by certain products or materials, a localized sensitivity or allergic response is often the cause. A common offender is Sodium Lauryl Sulfate (SLS), a detergent found in many toothpastes and oral hygiene products. SLS can strip the protective mucin layer coating the oral mucosa, leading to irritation and increased sensitivity.
Flavoring agents, most notably cinnamaldehyde found in cinnamon, frequently cause allergic contact stomatitis, a delayed hypersensitivity reaction. This reaction causes localized inflammation and a burning feeling, often stemming from cinnamon-flavored gum or toothpaste. In rare cases, individuals develop a delayed hypersensitivity to metals used in dental restorations like amalgam fillings or crowns. The slow release of metal ions can trigger a localized immune response that results in chronic burning or an altered taste sensation.
When all other local, systemic, and contact causes have been medically ruled out, the diagnosis may be Burning Mouth Syndrome (BMS). BMS is an idiopathic condition characterized by chronic, unexplained oral burning, believed to be a form of neuropathic pain. It is a diagnosis of exclusion, meaning it is only assigned after a thorough medical workup has failed to identify secondary causes.
Home Care, Prevention, and When to Consult a Doctor
Immediate Relief and Prevention
For immediate relief from a burning tongue, simple home care measures can provide temporary comfort. Sipping cool water or sucking on ice chips helps to soothe irritated nerve endings and temporarily desensitize the area. It is helpful to avoid known irritants, such as hot, spicy, or highly acidic foods, as well as alcohol-based mouthwashes, which can further dry the oral tissue.
Prevention involves modifying daily habits based on the suspected cause. If a contact sensitivity is suspected, switching to a bland, SLS-free, and cinnamon-free toothpaste is recommended. Maintaining meticulous oral hygiene and stimulating saliva flow by chewing sugar-free gum can help counteract dryness and reduce the risk of secondary infections. If GERD is a factor, elevating the head of the bed and avoiding eating close to bedtime can help minimize nighttime reflux.
Consulting a medical professional is advisable if the burning sensation is persistent, severe, or accompanied by other concerning symptoms, such as a visible change in tongue color or texture, swelling, or difficulty swallowing. A doctor will typically begin with a full blood panel to screen for nutritional deficiencies, including B vitamins, iron, and folate, and to check for conditions like diabetes. An oral swab can be used to test for a fungal infection, and patch testing may identify contact allergies to dental products or metals. If reflux is suspected, a gastric reflux test can confirm the presence of stomach acid in the upper airway.