Can vitamin deficiency from inadequate food intake cause a burning sensation on the tongue and a sensation of teeth movement or squeezing?

Vitamin Deficiency and Oral Sensory Symptoms

Yes, vitamin deficiencies from inadequate food intake can cause burning tongue sensation, though the sensation of teeth moving or being squeezed together is not a recognized manifestation of nutritional deficiency and suggests alternative diagnoses such as bruxism, temporomandibular joint disorder, or periodontal disease.

Burning Tongue (Glossodynia) and Vitamin Deficiency

B Vitamin Deficiencies as Primary Causes

Riboflavin (vitamin B2) deficiency is a well-established cause of burning tongue and oral symptoms. 1

• Riboflavin deficiency manifests with oral-buccal lesions including glossitis (tongue inflammation), angular stomatitis, and cheilosis 1
• In patients with burning mouth syndrome, vitamin B2 deficiency was found in 15% of cases, making it one of the most common deficiencies identified 2
• The deficiency causes these symptoms through impaired cellular metabolism and tissue integrity 1

Multiple B vitamin deficiencies commonly occur together and produce overlapping oral symptoms. 3

• Vitamin B6 deficiency was present in 5.7% of burning mouth syndrome patients 2
• Vitamin B1 (thiamine) deficiency occurred in 5.3% of cases 2
• Niacin (vitamin B3) deficiency can produce glossodynia with tongue swelling, papillary atrophy, and surface ulceration 3
• Patients commonly suffer from multiple nutritional deficiencies simultaneously, complicating the clinical picture 3

Other Vitamin Deficiencies

Vitamin B12 deficiency causes glossitis but is relatively uncommon as an isolated cause of burning tongue. 4, 3

• Only 0.8% of burning mouth syndrome patients had vitamin B12 deficiency in a large screening study 2
• However, B12 deficiency can present with oral symptoms including glossitis before hematologic changes appear 4
• Neurological symptoms often precede anemia, which may be absent in one-third of cases 5

Vitamin D deficiency has been associated with burning tongue in specific contexts. 6

• Vitamin D deficiency was found in 15% of burning mouth syndrome patients 2
• The mechanism may involve xerostomia (dry mouth) and altered taste perception 6
• This association appears particularly relevant in patients with concurrent diabetes 6

Folate deficiency rarely causes isolated burning tongue symptoms. 2

• Only 0.7% of burning mouth syndrome patients had folate deficiency 2
• When present, it typically occurs with other B vitamin deficiencies 3

Diagnostic Approach

Initial Screening

When evaluating burning tongue with suspected nutritional deficiency, screen for the most common deficiencies first. 2

• Check vitamin D (D2 and D3), vitamin B2 (riboflavin), vitamin B6, zinc, and vitamin B1 (thiamine) 2
• Include fasting blood glucose and TSH, as these were abnormal in 23.7% and 8.4% of cases respectively 2
• Complete blood count with red cell indices, serum iron, vitamin B12, and folate levels should be performed 3

Important Caveats

Clinical diagnosis of specific nutritional deficiency based on oral symptoms alone is not advisable. 3

• Multiple deficiencies commonly coexist, making clinical differentiation unreliable 3
• Laboratory confirmation is essential before initiating replacement therapy 3
• Standard serum B12 tests may miss functional deficiency in up to 50% of cases with metabolic deficiency 4

The Teeth Movement/Squeezing Sensation

The sensation of teeth moving or being squeezed together is NOT a recognized manifestation of vitamin deficiency.

This symptom suggests alternative diagnoses:

• Bruxism (teeth grinding/clenching), which can occur during sleep or waking hours
• Temporomandibular joint disorder causing referred sensations
• Periodontal disease with actual tooth mobility
• Anxiety or stress-related somatization
• Malocclusion or recent dental work

No evidence in the provided guidelines or research literature links vitamin deficiency to sensations of tooth movement or pressure. The neurological manifestations of vitamin deficiencies (particularly B vitamins) affect peripheral nerves in a symmetric, distal pattern rather than causing localized dental sensations 5, 7.

Treatment Considerations

Once nutritional deficiency is confirmed through laboratory testing, replacement therapy is highly effective and can prevent serious complications. 3

• Identification through early oral symptoms can forestall irreversible systemic and neurologic damage 3
• Riboflavin deficiency requires supplementation, with doses of 1.6 mg/day effective in elderly patients 1
• For vitamin B12 deficiency, oral supplementation of 1000-2000 μg daily is as effective as intramuscular administration for most patients 4
• Treatment should continue until levels normalize, followed by maintenance therapy 4