BMS is relatively uncommon, with estimates suggesting it affects about 1% to 5% of the general population. It is more frequently observed in middle-aged and older adults, particularly postmenopausal people over age 60, who account for a significant proportion of cases. The condition is rarely reported in younger individuals.

The exact cause of primary BMS is unknown. It is thought to involve a complex interplay of neurological, hormonal, and psychological factors. Secondary BMS can result from various underlying conditions such as:

• Nutritional Deficiencies: Deficiencies in vitamins B12, iron, or folate.

• Oral Infections: Fungal infections like candidiasis.

• Dry Mouth: Conditions like Sjögren’s syndrome or medications that reduce saliva production.

• Hormonal Changes: Particularly those associated with menopause.

• Psychological Factors: Anxiety, depression, and chronic stress.

• Acid Reflux

• Allergies

One’s genetic ability to detect taste has been shown to have a correlation with developing burning mouth syndrome. Divided into three categories, there are nontasters who don’t taste very strongly, medium tasters who taste things on a level considered most common, and supertasters who taste things really strongly. BMS commonly occurs in people self-diagnosed as supertasters who have begun to lose their sense of taste.

The hallmark symptom of BMS is a burning or scalding sensation in the mouth, often described as similar to consuming hot liquids. Other symptoms may include:

• Dry Mouth: A feeling of dryness or stickiness in the mouth.

• Taste Changes: Altered taste perception, including a bitter or metallic taste.

• Increased Thirst: A frequent need to drink water.

• Oral Discomfort: Tingling, numbness, or soreness, especially on the tongue and inner lips. Symptoms typically persist for months or years and can vary in intensity throughout the day, often worsening in the late afternoon or evening.

Diagnosing BMS involves excluding other potential causes of the burning sensation. A thorough medical history, physical examination, and various tests are used to rule out other conditions. BMS is diagnosed by exclusion, meaning all other potential causes must be ruled out before confirming the diagnosis.

• Blood Tests: To check for nutritional deficiencies, thyroid function, and other systemic conditions.

• Oral Swab or Biopsy: To identify fungal or bacterial infections.

• Salivary Tests: To assess saliva production and rule out dry mouth conditions.

• Allergy Testing: To determine if allergic reactions to oral products or foods contribute to symptoms.

Neurological Tests: In some cases, to assess nerve function and rule out neuropathies.

Treatment for BMS focuses on managing symptoms, as there is no definitive cure for the condition. Management strategies include:

• Medications: Tricyclic antidepressants, benzodiazepines, or anticonvulsants may help reduce pain. Topical anesthetics can provide temporary relief.

• Nutritional Supplements: For patients with deficiencies in vitamins or minerals.

• Saliva Substitutes: To alleviate dry mouth symptoms.

• Psychological Support: Cognitive-behavioral therapy (CBT) or counseling can help manage stress, anxiety, and depression, which may exacerbate symptoms.

• Avoidance of Irritants: Patients are advised to avoid tobacco, alcohol, spicy foods, and abrasive dental products.

The prognosis for BMS varies. Some individuals may experience spontaneous resolution of symptoms, while others have persistent discomfort despite treatment. Effective symptom management through a multidisciplinary approach involving healthcare providers, dentists, and mental health professionals can improve the quality of life for patients. Regular follow-up is crucial to monitor symptoms and adjust treatment plans as needed.

1. Cleveland Clinic

2. Oral Health Foundation

3. Mayo Clinic