Understanding burning mouth syndrome

You wake up and your tongue, lips, or sections of your mouth are burning, as though you'd just taken a gulp of scalding coffee. It could be burning mouth syndrome (BMS), a condition as odd as it sounds.

No one knows what causes burning mouth syndrome, which affects up to 15% of people worldwide. Because it appears most frequently in postmenopausal women and in seven times as many women as men, shifting hormones may play a part.

• The pain starts slowly, building through the day, reaching its peak in the evening and sometimes it can be so severe it keeps you awake or it can blink on and off like a light in fog.
• Other symptoms of BMS include burning, tingling, dryness, a new taste of metal or bitterness in your mouth, and depression.
• BMS may be linked to other conditions such as  anxiety and depression; other chronic pain conditions such as headaches; high blood-sugar levels; and deficiency in B vitamins, iron, and zinc.
• Dry mouth or other oral conditions such as thrush, a yeast infection, or geographic tongue in which patches of the normal bumps, or papillae, on the tongue are missing, giving the tongue a map-like look may also play a part.
• Some studies suggest BMS may be caused when certain nerves affecting taste are out of whack.

Besides pain, your first reaction to burning mouth syndrome will probably be bewilderment. However, as with any painful condition, there are steps you can take right away to help.

• First, visit your doctor. When it comes to BMS, your doctor's bag is brimming with effective treatments. The most important step is figuring out what triggered your disease.
• Your doctor will begin by examining your mouth, taking your medical history, and asking about your oral routine. The doctor may also give you blood and allergy tests as well as a mouth swab to test for oral candidiasis, a yeast infection often called thrush.
• Depending on the examinations and test findings, your doctor may then refer you to a specialist who can help relieve your symptoms.
• Because the syndrome has many possible causes and symptoms, treatment has to be customized. In general, it's treated as other nerve pain conditions are, with low doses of anti-anxiety drugs, tricyclic antidepressants, and anti-convulsants.