Merck Manual

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Burning Mouth Syndrome

(Glossodynia; Oral Dysesthesia; Burning Tongue)

By

Bernard J. Hennessy

, DDS, Texas A&M University, College of Dentistry

Last full review/revision May 2020| Content last modified May 2020
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Burning mouth syndrome is intraoral pain, usually involving the tongue, in the absence of intraoral physical signs. There are no specific diagnostic tests, and treatment is symptomatic. Burning mouth syndrome can be either idiopathic or caused by another disorder (secondary).

Burning mouth syndrome usually affects postmenopausal women. It is believed to be neurogenic, affecting nerves of pain and taste. Causes of secondary burning mouth syndrome include

Burning mouth syndrome may cause burning, tingling, or numbness of the tongue or other areas of the mouth, including the lips. The pain may be constant or increase throughout the day and may be relieved by eating or drinking. Dry mouth or altered taste may occur. Duration of symptoms of burning mouth syndrome is variable and may recur if the cause is not addressed.

Diagnosis of Burning Mouth Syndrome

  • Clinical evaluation

Diagnosis of burning mouth syndrome requires oral symptoms as noted above and the absence of oral signs. Pain must occur for > 2 hours a day for > 3 months. There are no diagnostic tests for burning mouth syndrome. Idiopathic burning mouth syndrome is a diagnosis of exclusion; therefore, secondary causes should be sought.

Treatment of Burning Mouth Syndrome

  • Symptomatic treatment

  • Curative treatment for secondary burning mouth syndrome

Pain of burning mouth syndrome may be relieved with cold beverages, ice chips, chewing gum (sugarless), and by avoidance of irritants such as tobacco, spicy or acidic foods, and alcohol (in beverages and mouthwash). Tricyclic antidepressants, alpha-lipoic acid, clonazepam, topical capsaicin, gabapentin, vitamin supplementation (B and C), and cognitive-behavioral therapy may sometimes help.

Secondary burning mouth syndrome may be cured by appropriate treatment of the underlying cause.

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Tongue Discoloration and Other Changes
A 12-year-old girl is brought to the office by her grandmother because she has had pain in her mouth for the past week. The patient appears to be drooling. Physical examination shows a smooth red tongue. Tenderness is noted on palpation of the oral mucosa. Based on these findings, this patient most likely has a deficiency of which of the following? 
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