Causes of Burning Mouth

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Causes of Burning Mouth
Authored By: Allison DiMatteo
Reviewed By: Mahnaz Fatahzadeh, DMD

The exact cause of the condition is still not clearly understood. A burning sensation or symptom in the mouth can result from, or be a symptom of, a number of oral and systemic conditions. These problems must be ruled out before a diagnosis of “burning mouth syndrome” can be made.

Some of the factors contributing to oral burning include:

Nutritional deficiencies: Deficiencies of iron, folate and vitamin B complex have been associated with a burning sensation in the mouth. As a result, some treatment approaches have included supplements of B vitamins and minerals like zinc and iron. (Read more about diet and dentistry)

Dry Mouth (xerostomia): Medications, Sjogren's syndrome and any number of other causes can lead to dry mouth and its related burning sensation. Sipping liquids throughout the day, using artificial saliva and/or eliminating the cause of the dry mouth may reduce or eliminate the burning sensation.

Oral Candidiasis (Oral Thrush): A symptom of this oral fungal infection is a burning sensation in the mouth, particularly when consuming acidic or spicy foods, or when the cottage-cheese like lesions are scraped from the inside of the mouth. The plan that your dentist recommends to treat oral thrush can help end the burning sensations associated with this oral yeast infection.

Diabetes: Diabetics are more susceptible to oral infections (including oral thrush) that produce burning mouth sensations. Additionally, diabetics are prone to vascular changes that affect the small blood vessels in the mouth, creating a lower threshold for pain. A better control of blood sugar levels in diabetic patients may prevent onset or help improve symptoms of burning mouth.

Menopause: Hormonal changes have been associated with a burning sensation in the mouth in middle-aged women. Burning mouth is among the most common oral manifestations of menopause. However, hormone replacement therapy has only been effective in relieving burning mouth symptoms in certain patients.

Anxiety/Depression: Psychological problems do not directly cause burning mouth but could aggravate these symptoms or even result from the frustration patients experience dealing with their chronic pain. Anxiety or depression may have a role in initiation of destructive oral habits such as tooth grinding (bruxism) or tongue thrusting which can further irritate burning lips and mouth. Stress may also lead to alteration of the flow or composition of the saliva, exacerbating the oral burning.

Other: Additional causes of burning mouth symptoms could be physical irritation from dentures, contact allergy to denture components (contact stomatitis) or oral hygiene products (Sodium Lauryl sulfate in toothpastes), gastroesophageal reflux disease, low levels of thyroid hormones, certain antihypertensive medications, changes in salivary composition, tongue thrusting and cancer therapy.

If you are experiencing burning sensations in your mouth, it is important that you visit your dentist as soon as possible to discuss your symptoms and undergo an examination. Your dentist will likely review your complete medical history and perform a thorough oral examination in order to help identify the local cause of the burning sensations in your mouth. If oral thrush (oral fungal infection), dry mouth, oral sores or other oral/dental issues are ruled out as the cause, you may be referred to a physician or an oral medicine practitioner for further evaluation and treatment.

Blood work and other diagnostic tests may be necessary to look for infection, nutritional deficiencies, diabetes or thyroid problems, Sjogren's syndrome and allergy. Once identified, treatment is directed against the cause of burning mouth symptoms.

In the absence of local or systemic causes for oral burning sensations, the condition is diagnosed as burning mouth syndrome thought to be caused by neuropathy or dysfunction of the nerves involved in the perception of pain and taste sensations from the oral cavity.

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