What are the causes of a burning tongue sensation?

From the Guidelines

A burning tongue sensation can be caused by several conditions, with burning mouth syndrome being a common cause, characterized by chronic burning without visible abnormalities, as noted in a study published in the British Journal of Anaesthesia 1. The causes of a burning tongue sensation can be diverse, including:

• Burning mouth syndrome, which is a rare chronic condition characterized by burning of the tongue and other parts of the oral mucosa in which no dental or medical causes are found, predominantly seen in peri- and post-menopausal women 1
• Secondary causes of burning mouth syndrome, such as oral candidiasis, mucosal lesions, haematological disorders, auto-immune disorders, and pharmacological side-effects 1
• Oral dysesthesia, which is generally described as oral pain with a “burning” sensation in the absence of, or disproportionate to, skin changes, oral sensitivity, dysgeusia, phantogeusia, or other altered sensation with normal clinical findings, as described in the NCCN guidelines for management of immunotherapy-related toxicities, version 2.2024 1
• Other potential causes, such as dry mouth, acid reflux, allergic reactions, oral infections, hormonal changes, nerve damage, and certain medications, including ACE inhibitors, antidepressants, and some blood pressure medications Treatment depends on identifying the underlying cause, which may require blood tests to check for deficiencies or medical evaluation to rule out systemic conditions, and management options may include dietary modifications, topical measures, and medications such as gabapentin or steroids, as recommended in the NCCN guidelines 1.

From the Research

Causes of Burning Tongue Sensation

The causes of a burning tongue sensation can be varied and complex. Some of the possible causes include:

• Nutritional deficiencies, such as a lack of vitamins or minerals 2
• Mucosal disease, including conditions like oral lichen planus 3
• Fungal infections, such as candidal infections 3
• Hormonal disturbances, including changes associated with menopause 4, 5
• Contact stomatitis, which can be caused by certain medications or substances 2
• Neuropathic changes in the tongue, which can lead to altered sensory processing 4
• Systemic diseases, such as diabetes mellitus 4, 5
• Medications, including angiotensin-converting enzyme (ACE) inhibitors 6
• Local oral infections, such as denture-related lesions or xerostomia 5
• Hypersensitivity reactions, which can be caused by certain substances or medications 5

Secondary Causes of Burning Tongue Sensation

In some cases, the burning tongue sensation can be secondary to another condition or factor. These secondary causes can include:

• Other clinical abnormalities, such as gastrointestinal disorders or respiratory diseases 4
• Psychotropic medicines, which can contribute to the development of burning mouth syndrome 6
• Antihypertensive medicines, such as ACE inhibitors, which can induce burning mouth syndrome 6
• Local oral conditions, such as geographic tongue or fissured tongue, which can cause discomfort or pain in the tongue 3