Have you ever had an unsolicited numbness or burning sensation in your mouth? If so, it may be Burning Mouth Syndrome (BMS).
Burning mouth is the sensation of burning in the tongue and often the palate; however, it may also occur anywhere in the mouth. The sensation is commonly described as the discomfort felt when the tongue is burned with hot coffee. Additionally, it may be described as a tender, tingling, hot, scalding, or numb sensation. Most individuals with BMS find the burning sensation gets worse throughout the day. The mouth may feel fine in the morning only to develop burning in the evening. Once asleep, the pain seems to lessen. The next morning the cycle reoccurs. BMS sufferers may also have alterations in taste and salivation.
BMS mainly affects females in the fifth to seventh decades usually presenting 3 years before to 12 years following menopause and rarely before the age of 30. BMS onset can either be gradual, spontaneous, or related to a precipitation event. The condition may last for a couple of months or even years. About 1/3 of those with a burning tongue will improve over 3 to 5 years without any treatment at all.
The cause of BMS is still up for debate. One theory suggests there is a relationship between burning mouth syndrome and tastes changes. Research has shown that many people with burning mouth have a loss of bitter taste buds at the tip of the tongue. The theory is that taste inhibits pain, but when the ability to taste bitter is lost, pain fibers begin to “fire” spontaneously. Since burning mouth is more common in post-menopausal women, another theory suggests that BMS is related to decreased estrogen levels, which causes the decline in the sensitivity of the taste buds.
Since many conditions can also cause a burning sensation in the mouth, BMS is a diagnosis of last result. Dry mouth, acid reflux, hormonal disorders, allergies, medications, infections, and nutritional deficiencies can also cause a burning sensation in the mouth. Therefore, these conditions must be screened for before a diagnosis of Burning Mouth Syndrome can be given. If BMS is diagnosed, it is usually treated with low doses of centrally acting medications like clonazepam or gabapentin. Topical clonazepam, topical capsaicin, nutritional supplements, or hormonal replacement therapies are some other treatments that may be used.