Burning Mouth Syndrome: Or something else? Differential Diagnosis

Blood, hematopoietic organs-immune system (D50-D90).

  • Iron-deficiency anemia – anemia caused by iron deficiency.
  • Immunodeficiency/deficiency → candidiasis (synonyms: candidasis, candidosis).
  • Pernicious anemia – anemia (anemia) caused by a deficiency of vitamin B12 or, less commonly, folic acid deficiency.
  • Plummer-Vinson syndrome (synonyms: sideropenic dysphagia, Paterson-Brown-Kelly syndrome) – combination of several symptoms caused by mucosal atrophy in the upper gastrointestinal tract (oral cavity to stomach); the disease leads to difficulty swallowing and burning of the tongue due to mucosal atrophy in the mouth, furthermore occur: Mucosal defects, oral rhagades (tears in the corner of the mouth), brittle nails and hair and dysphagia (difficulty swallowing) due to larger mucosal defects; the disease is a risk factor for the development of esophageal cancer (esophageal cancer).

Endocrine, nutritional, and metabolic diseases (E00-E90).

  • Diabetes mellitus (→ candidiasis)
  • Iron deficiency
  • Folic acid deficiency
  • Food intolerances, such as cinnamon intolerance.
  • Vitamin B6 deficiency
  • Vitamin B12 deficiency
  • Zinc deficiency

Cardiovascular system (I00-I99)

  • Osler-Weber-Rendu disease (synonyms: Osler disease; Osler syndrome; Osler-Weber-Rendu disease; Osler-Rendu-Weber disease; hereditary hemorrhagic telangiectasia, HHT) – autosomal-dominant inherited disorder in which telangiectasias (abnormal dilation of blood vessels) occur. These can occur anywhere, but are found especially in the nose (leading symptom: epistaxis (nosebleed)), mouth, face, and the mucous membranes of the gastrointestinal tract. Because the telangiectasias are very vulnerable, it is easy to tear and thus bleeding.

Skin and subcutaneous (L00-L99).

  • Lichen ruber planus (nodular lichen) – description of small flat, slightly scaly nodules here: Lichen ruber mucosae oris; burning tongue pain may occur before the appearance of visible changes.

Infectious and parasitic diseases (A00-B99).

  • Candidiasis – infectious diseases caused by fungi (fungi sprouts) of the genus Candida (here: inflammation of the oral mucosa, including the tongue).
  • Helicobacter pylori infection
  • HIV infection – burning mouth is described as an indication of early-stage HIV infection

Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93).

  • Gastroesophageal reflux disease (synonyms: GERD, gastroesophageal reflux disease; gastroesophageal reflux disease (GERD); gastroesophageal reflux disease (reflux disease); gastroesophageal reflux; reflux esophagitis; reflux disease; Reflux esophagitis; peptic esophagitis) – inflammatory disease of the esophagus (esophagitis) caused by the pathological reflux (reflux) of acid gastric juice and other gastric contents.
  • Gingivostomatitis ulcerosa/ulcerous inflammation of the gums and oral mucosa (forms: Plaut-Vincent due tomixed bacterial infection; agranulocytosis /absence or severe decrease of granulocytes in the blood due tointolerance reactions).
  • Laryngopharyngeal reflux (LRP) – “silent reflux” in which the cardinal symptoms of gastroesophageal reflux, such as heartburn and regurgitation (backflow of food pulp from the esophagus into the mouth), are absent.
  • Lingua geographica (map tongue): harmless change in the tongue surface; constitutional anomaly; the tongue gets its typical appearance by shedding the epithelium of the filiform papillae of the tongue surface (papillae filiformes); whitish and reddish districts resembling a map appear; spectrum of complaints ranges from asymptomatic to a burning sensation or burning pain.
  • Stomatitis forms oral mucositis:
  • Xerostomia (dry mouth).
  • Tongue fissure (mucous membrane tear in the tongue), usually painless.

Musculoskeletal system and connective tissue (M00-M99).

  • Sjögren’s syndrome – autoimmune disease from the group of collagenoses leading to chronic inflammatory disease or destruction of the exocrine glands, with the salivary and lacrimal glands most commonly affected.

Psyche – Nervous System (F00-F99; G00-G99).

  • Anxiety
  • Anorexia nervosa (Anorexia)
  • Bulimia nervosa (BN; binge eating disorder)
  • Depression

Injuries, poisonings and other consequences of external causes (S00-T98).

  • Allergies, unspecified: e.g.
    • Food allergies or
    • Allergies to food ingredients: e.g. flavor enhancers, preservatives (e.g. benzoic acid), food colors, stabilizers (e.g. ascorbic acid).
  • Injuries to the tongue (eg, burns from food, drink).

Medications

Medications that can lead to xerostomia (dry mouth).

Drugs that can cause burning of the mouth

  • Mouthwashes
  • Reserpine

Radiotherapy

Other differential diagnoses

  • Electrogalvanic voltage differences of dental fillings (amalgam, dentures, plastics).
  • Poorly fitting / unmaintained dentures.
  • Incompatibility of the denture material
  • Tongue habit, unspecified

Other causes

  • Ill-fitting/maintained dentures.
  • Incompatibility of the denture material
  • Tongue habit, unspecified