• Reference Number: HEY-1353/2023
• Departments: Oral Surgery, Dentistry and Max Fax
• Last Updated: 1 January 2023

Introduction

This leaflet has been produced to give you general information. Most of your questions should be answered by this leaflet. It is not intended to replace the discussion between you and the healthcare team, but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

What is Burning Mouth Syndrome?

Burning Mouth Syndrome (BMS) is a name given to discomfort or pain in the mouth. It often affects the tongue, lips and cheeks but other parts of the lining inside the mouth can also feel uncomfortable.

BMS is a common condition. It often affects women, particularly after the menopause, but men can sometimes get it too. Up to one in three older women report noticing a burning sensation in their mouth.

Signs and Symptoms

Moderate to severe burning in the mouth is the main symptom of BMS and can persist for months or years. For many people, the burning sensation begins in late morning, builds to a peak by evening, and often subsides at night. Some feel constant pain; for others, pain comes and goes. Other symptoms of BMS include:

• Tingling or numbness on the tip of the tongue or in the mouth.
• Bitter or metallic changes in taste.
• Dry or sore mouth.

What is the cause?

The sensation of burning in the mouth can occasionally be the result of a range of medical or dental problems including:

• Hormonal changes around the menopause
• Dry mouth, which can be caused by many medicines and disorders such as Sjögren’s syndrome or diabetes
• Oral candidiasis, a fungal infection in the mouth
• Acid reflux (heartburn)
• Poorly-fitting dentures or allergies to denture materials.
• Blood or vitamin deficiencies

It can also occur or get worse when somebody is stressed, anxious or depressed, or going through a difficult time of life. Sometimes there is no obvious cause of burning. Not knowing why your mouth is burning can also make you anxious.

The connection can be unclear, and the exact cause of burning mouth syndrome cannot always be identified with certainty.

If you describe a burning sensation in your mouth you will be examined thoroughly to make sure another medical or dental cause is not responsible.

Sometimes people get worried that they may have mouth cancer. This is quite a common anxiety of people with burning mouth syndrome. Carrying out a thorough examination and any necessary tests will enable your doctor to reassure you that all is normal with no signs of cancer.

Diagnosis

A review of your medical history, a thorough oral examination, and a general examination may help identify the source of your burning mouth. Tests may include:

• Blood tests to look for infection, nutritional deficiencies, and disorders associated with BMS such as diabetes or thyroid problems.
• Oral swab/rinse to check for thrush (only if necessary).
• Rarely allergy testing for denture materials, certain foods, or other substances that may be causing your symptoms.

Treatment

Treatment should be tailored to your individual needs. Depending on the cause of your BMS symptoms, possible treatments may include:

• Adjusting or replacing irritating dentures with your dentist
• Treating existing disorders such as diabetes, Sjögren’s syndrome, or a thyroid problem to improve burning mouth symptoms
• Recommending supplements for nutritional deficiencies
• Switching medicine, where possible, if a drug you are taking is causing your burning mouth
• prescribing medications to:

– Relieve dry mouth

– Treat oral candidiasis

– Help control pain from nerve damage

– Relieve anxiety and depression.

When no underlying cause can be found which is in the majority of cases, treatment is aimed at the symptoms to try to reduce the pain associated with burning mouth syndrome.

Is there any treatment?

Symptoms often improve following reassurance that there is no serious disease present in the mouth. The burning feelings can sometimes be worse at times of stress and go away when life is running more smoothly.

In the same way that low doses of antidepressants can help patients with neuralgia even if they are not depressed, sometimes low doses of antidepressants can relieve the symptoms of burning mouth syndrome (e.g. 10mg Amitriptyline to be taken at night). There is also some evidence to support the use of Alpha Lipoic Acid supplements that can be obtained from stores/on-line from companies like “Holland & Barrett”.

What if I don’t get better?

We know that we can’t always make you better. Trying not to focus on the feeling, learning to live with the sensation, and remembering that no serious disease has been found can sometimes be the best way of managing this common problem.

Helpful Tips

You can also try these self-care tips to help ease the pain of burning mouth syndrome.

• Sip water frequently.
• Suck on ice chips.
• Avoid irritating substances like hot, spicy foods; mouthwashes that contain alcohol; and products high in acid, like citrus fruits and juices.
• Chew sugar free gum.
• Avoid alcohol and tobacco products.

This leaflet was produced by the Oral and Maxillofacial Surgery Department, Hull University Teaching Hospitals NHS Trust and will be reviewed in 2026

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.