Burning tongue: what can be behind it?

If the tongue burns and hurts temporarily, it is often caused by too spicy foods. However, persistent burning on the tongue is a nagging symptom that can occur as part of various illnesses, as a result of medication, or with no identifiable cause.

In the case of a burning tongue, a comprehensive diagnosis is essential to identify and treat any causal diseases. We have compiled an overview of possible causes for you and tips on what you can do against a burning tongue.

How does tongue burning occur?

The uncomfortable sensation of a burning tongue usually occurs when the nerve fibres in the tongue responsible for pain and heat send a stimulus to the brain. This is the case, for example, when we eat something hot or spicy.

In addition, various other substances can irritate the nerve fibres; for example, smoking or eating pineapple can cause a burning sensation on the tongue. This is then a natural body reaction and should not be considered pathological.

 

Burning Mouth Syndrome: Chronic burning sensation in the mouth

Burning Mouth Syndrome (BMS) describes chronic burning pain in the mouth for which no cause can be found. The tongue often burns at the front and sides, and the palate, throat and gums can also be affected. Some sufferers also suffer from dry mouth or taste disorders.

Most of the time, no change is visible on the tongue with burning mouth syndrome. On the other hand, tongue coating, blisters, pimples or red spots are often an indication of underlying diseases. Then, the symptoms are referred to as secondary, i.e., caused by other diseases, such as burning the tongue.

Burning tongue without cause

Burning Mouth Syndrome is an independent clinical picture that affects around three to four per cent of adults in Germany. The cause still needs to be sufficiently researched – but it is assumed that it is a pathological change in the nerve fibres responsible for pain.

Women are about seven times more likely than men to suffer from Burning Mouth Syndrome. The symptoms often begin with the onset of menopause. Stressful events or mental illnesses such as depression are also considered to be favourable factors for Burning Mouth Syndrome.

What Causes Burning Tongue?

Eine brennende Zunge kann jedoch auch im Rahmen verschiedener Erkrankungen auftreten oder durch andere Faktoren verursacht werden. In diesen Fällen spricht man von sekundärem oder symptomatischem Zungenbrennen. Unter anderem können folgende Ursachen dahinterstecken:

• Allergie: Eine Nahrungsmittelallergie kann sich beim Verzehr der entsprechenden Lebensmittel durch ein Brennen auf der Zunge äußern. Oftmals kommt es außerdem zu Juckreiz und einem pelziges Gefühl im Mund. Häufig sind auch Kreuzallergien bei Heuschnupfen die Ursache.
• Eisen- und Vitaminmangel: Zungenbrennen kann Anzeichen eines Vitaminmangels sein. So können sich eine Unterversorgung mit Vitamin B6, Vitamin B12 oder Folsäure sowie ein Eisenmangel durch eine brennende Zunge äußern. Häufig betroffen sind Patienten mit Zöliakie (Gluten-Unverträglichkeit), bei der die Nährstoffaufnahme im Darm vermindert ist.
• Zahnerkrankungen: Schlecht sitzende Prothesen, Zahnfleischentzündungen, Karies oder andere orale Infektionen können ein Brennen im Mund und auf der Zunge hervorrufen.
• Mundschleimhautentzündung: Eine Entzündung oder Reizung der Mundschleimhaut tritt oftmals aufgrund einer Chemotherapie oder Bestrahlung auf. Zudem kann der häufige Kontakt mit Säure – etwa bei Sodbrennen oder Ess-Brech-Sucht – zu einer Mundschleimhautentzündung führen.
• Pilzinfektion: Wenn die Zunge brennt und belegt ist, kann das auf eine Infektion mit einem Pilz (Mundsoor) hinweisen. Der weiße Belag ist abstreifbar und kann auch auf Gaumen und Wangen auftreten. Mundsoor tritt häufig bei einer Immunsuppression, etwa durch eine Chemotherapie oder eine HIV-Infektion, auf.
• Mundfäule: Schmerzende oder brennende weiße Bläschen auf der Zunge können Symptom der Mundfäule (Stomatitis aphtosa) sein. Die Erkrankung wird durch eine Herpes-Virusinfektion verursacht und tritt insbesondere bei Kindern sowie bei Menschen mit geschwächtem Immunsystem auf.
• Medication:  Various medications can cause burning tongue as a side effect. These include, for example, certain medicines for  high blood pressure  , blood pressure medicines (so-called ACE inhibitors and angiotensin receptor blockers), antidepressants, sedatives and some  antibiotics  and viral medicines.
• Diabetes  mellitus:  Burning tongue is often caused by undetected or poorly controlled diabetes mellitus. A possible reason is the so-called diabetic neuropathy, which causes abnormal sensations such as pain, burning or tingling in various parts of the body due to nerve damage.
• Neurological diseases:  Diseases that involve nerve damage, such as  multiple sclerosis , are possible causes of burning tongue.
• Autoimmune diseases  such as  lupus  erythematosus or  systemic scleroderma  can cause burning in the tongue and mouth. In Sjörgen syndrome, saliva production is reduced, which can lead to dry mouth and a burning tongue.
• “Map tongue”:  A so-called map tongue has irregular white and red spots on the tongue that are reminiscent of the image of a map. In addition, burning of the tongue can occur. The cause of a map tongue is unknown, but the change is harmless.
• “Tongue cancer”:  In very rare cases, a painful or burning change on the tongue can be an indication of a tumor (oral cavity carcinoma).
• Scarlet fever:  With scarlet fever, there is typically a white coating on the tongue at the beginning, later the tongue becomes bright red with red dots (“raspberry tongue”). Pain or a burning sensation on the tongue can occur, but flu-like symptoms such as  a sore throat  and  difficulty swallowing are  the main symptoms.

Burning tongue: when to see a doctor?

If you suffer from unexplained burning tongue for several days or recurrently, you should have the symptoms clarified by a doctor. This also applies if you notice visual changes on your tongue.

The question  “Who treats burning tongue?”  is not an easy question to answer: Depending on the cause, dentists, dermatologists, ENT doctors, neurologists, internists and psychosomaticians can be involved in the treatment. A good first point of contact is usually your family doctor – he or she knows you best as a patient and can refer you to a suitable specialist.

 

 

 

Cure for burning tongue?

Treatment for secondary tongue burning depends on the cause: If the trigger is treated successfully, the burning sensation often disappears or at least improves.

Burning Mouth Syndrome, however, cannot yet be cured by any therapy. However, spontaneous  healing  can occur: in around half of those affected, the burning sensation on the tongue disappears as suddenly as it appeared.

 

Treatment of burning tongue: what helps?

There are a few treatment options available to relieve the symptoms of a burning tongue:

• Mouthwashes  or lozenges that contain anti-inflammatory or topical anesthetic agents such as lidocaine can help with burning tongue. Preparations containing the active ingredient capsaicin have also proven to be effective.
• Saliva substitute products  can be useful for dry mouth.
• Alpha lipoic acid  is used for diabetic neuropathy and has proven effective in the treatment of burning tongue. The medication is available from pharmacies without a prescription.
• Some  antidepressants  and  antiepileptic drugs  are approved to treat nerve pain and may be prescribed for burning tongue. Antidepressants can also improve symptoms through a positive effect on the psyche.
• Clonazepam  is a strong sedative that is used, among other things, for epilepsy and may only be taken as directed by a doctor. In severe cases of burning tongue, the medication can provide relief – simply sucking a tablet and then spitting it out can be effective.
• Psychotherapy  – especially so-called cognitive  behavioral therapy  – has proven to be very effective for burning tongues. Here, patients learn, among other things, how they can combat pain by controlling their thoughts and feelings.
• In the area of ​​alternative healing methods, there are some  homeopathy remedies  and  Schüßler Salts® that promise help with burning tongues.

There is no general answer to the question of how long a burning tongue can last. As a rule, however, patience is required during treatment: many of the medications only take effect after a few weeks.

What to do if your tongue burns?

In addition to medical treatment, there are some home remedies for burning tongue. We have put together six tips for you on what you can do if you have a burning tongue:

1. Teas or tinctures with  herbal active ingredients  such as sage, mallow leaves, linden blossoms, marshmallow roots or  aloe vera  have a soothing effect.
2. Gargling with  salt water  or  sucking on ice cubes  can provide relief.
3. Drink  enough fluids to prevent dry mouth. Suitable drinks include still water or herbal tea. It’s better to avoid fruit juices – they can irritate your tongue further.
4. Pay attention to careful  oral hygiene  and try out which care products are good for you. Avoid alcoholic mouthwashes and use a mild toothpaste.
5. Relaxation methods  such as autogenic training, meditation or yoga can improve psychological well-being and thus help to deal with pain.
6. Self-help groups  for patients with chronic pain offer support through exchanges with other sufferers.

What to eat if your tongue burns?

You should avoid potentially irritating foods whenever you suffer from tongue irritation. These include, for example, acidic fruits such as pineapple and citrus fruits, tomatoes, vinegar, carbonated drinks and coffee. Spicy foods, alcohol and nicotine also irritate the oral mucosa and can increase tongue burning.