From the Guidelines
Burning sensations in the tongue when consuming hot or cold foods and beverages are typically caused by a condition called burning mouth syndrome (BMS) or thermal hyperalgesia, as supported by the most recent study 1. This condition involves increased sensitivity of the tongue's nerve endings, making them react more intensely to temperature changes. Common causes include:
- Nerve damage
- Hormonal changes (especially during menopause)
- Nutritional deficiencies (particularly B vitamins, iron, or zinc)
- Dry mouth conditions
- Allergic reactions to dental products
- Acid reflux
- Certain medications
- Fungal infections like thrush
- Underlying medical conditions such as diabetes or thyroid problems. According to the study 1, treatment options for oral dysesthesia, which is generally described as oral pain with a “burning” sensation, include:
- Assessing the location and character of pain
- Ruling out odontogenic or mucosal source
- Assessing severity of pain and impact on function
- Holding immunotherapy
- Dietary modifications
- Gabapentin, high potency topical steroids (gel or dental paste preferred), or viscous lidocaine for moderate to severe cases. The burning sensation occurs because temperature-sensitive receptors (TRPV1 and TRPM8) in the tongue become hypersensitive, sending exaggerated pain signals to the brain when exposed to temperature extremes that wouldn't normally cause discomfort, as noted in the context of burning mouth syndrome 1.
From the FDA Drug Label
When using this product • You may experience a burning sensation. The cause of tongue burning is not directly mentioned in the context of the question, as the label warns against contact with mucous membranes, including the mouth, and does not specify the tongue.
- The burning sensation is mentioned as a possible reaction to the product, but it is not explicitly linked to the tongue.
- The label advises to avoid contact with the eyes, lips, nose and mucous membranes, implying that contact with these areas, including the tongue, should be avoided. 2
From the Research
Causes of Tongue Burning
The exact cause of tongue burning, also known as burning mouth syndrome (BMS), is not fully understood. However, several factors have been associated with the condition, including:
- Local or systemic factors, such as oral mucosal lesions or blood test alterations, which can cause secondary BMS 3
- Peripheral or central neuropathic disturbances, such as dysfunction of the sensory C and/or trigeminal nerve fibers or the nigrostriatal dopaminergic system 4
- Nutritional deficiencies, such as vitamin or mineral deficiencies 5
- Hormonal changes, such as those experienced during menopause 5
- Chronic anxiety or depression 5
- Changes in salivary function 5
- Dysfunction of cranial nerves associated with taste sensation 5
Characteristics of Burning Mouth Syndrome
BMS is characterized by:
- A burning sensation in the tongue or other oral sites, usually in the absence of clinical and laboratory findings 6, 7, 5
- Intense burning or itching sensation of the tongue or other regions of the oral mucosa 4
- Accompanying symptoms, such as xerostomia (dry mouth) and dysgeusia (altered taste) 4
- Spontaneous manifestation, with discomfort typically increasing in intensity during the evening and at night 4
Diagnosis and Treatment
Diagnosis of BMS requires the exclusion of oral mucosal lesions or blood test alterations that can produce burning mouth sensation 4. Treatment is based on the avoidance of causes of oral irritation and the provision of psychological support 4. Drug treatment for burning sensation in primary BMS of peripheral origin can consist of topical clonazepam, while central type BMS appears to improve with the use of antidepressants, antiseizure drugs, or amisulpride 4.