Burning mouth syndrome
The possible causes of burning mouth syndrome are many and complex. Each of the following possible causes applies to only a small portion of all people who complain of a burning mouth. More than one-third of people have multiple causes. Identifying all of the causes is important so that your doctor can develop a treatment plan tailored for you. Possible causes include:
Dry mouth (xerostomia). This condition can be related to use of certain medications, including tricyclic antidepressants, central nervous system depressants, lithium, diuretics and medications used to treat high blood pressure. It can also occur with aging or Sjogren's syndrome, an autoimmune disease that causes dry mouth and eyes.
Other oral conditions. Oral yeast infection (thrush) is a common cause of a burning mouth that may also occur with other causes, such as diabetes, denture use and certain medications. Geographic tongue, a condition that causes a dry mouth and a sore, patchy tongue, also may be associated with burning mouth syndrome.
Psychological factors. Emotional disorders, particularly depression but also anxiety and fear of cancer, are often associated with burning mouth syndrome. Although such problems can cause a burning mouth, they may also result from it.
Nutritional deficiencies. Being deficient in nutrients, such as iron, zinc, folate (vitamin B-9), thiamin (vitamin B-1), riboflavin (vitamin B-2), pyridoxine (vitamin B-6) and cobalamin (vitamin B-12), may affect your oral tissues and cause a burning mouth. These deficiencies can also lead to vitamin deficiency anemia.
Irritating dentures. Dentures may place stress on some of the muscles and tissues of your mouth. The materials used in dentures also may irritate the tissues in your mouth.
Nerve disturbance or damage (neuropathy). Damage to nerves that control taste and pain in the tongue may also result in a burning mouth.
Allergies. The mouth burning may be due to allergies or reactions to foods, food flavorings, other food additives, fragrances, dyes or other substances.
Reflux of stomach acid (gastroesophageal reflux disease). The sour- or bitter-tasting fluid that enters your mouth from your upper gastrointestinal tract may cause irritation and pain.
Certain medications. Angiotensin-converting enzyme (ACE) inhibitors, used to treat high blood pressure, may cause side effects that include a burning mouth.
Oral habits. These include often-unconscious activities such as tongue-thrusting and teeth-clenching (bruxism), which can irritate your mouth.
Endocrine disorders such as diabetes and underactive thyroid (hypothyroidism). Your oral tissues may react to high blood sugar levels that occur with diabetes.
Hormonal imbalances, such as those associated with menopause. Burning mouth syndrome occurs most commonly among postmenopausal women, although it affects many other people as well. Changes in hormones may affect the composition of your saliva.
Excessive irritation. Irritation of the oral tissues may result from excessive brushing of your tongue, overuse of mouthwashes or consuming too many acidic drinks.
Often, more than one cause is present. Despite careful evaluation, doctors are sometimes unable to find the cause of burning mouth symptoms.
By Mayo Clinic staff
September 23, 2004