Burning Mouth Syndrome

Posted 2/04/2010

Question:

My mouth feels like I just ate scalding soup when I haven’t. I am a 45 year old lady in otherwise good health. My dentist says my teeth, gums, and oral tissues are healthy. What’s going on?

Doctor's Response:

It sounds very much as if you have burning mouth syndrome. There are basically 2 types-one in which the cause is unknown and the other due to a definable disease. Infections such as thrush, dry mouth, poorly fitting dentures, vitamin deficiencies and emotional disturbances all may play a role. Medications, especially those that dry the mouth, may contribute. Blood tests can check your complete blood count, glucose level, thyroid function, nutritional factors and immune functioning, all of which may provide clues about the source of your mouth pain. Cultures of your mouth for thrush and other pathogens, allergy tests and tests for GERD (reflux of acid), saliva volume tests and psychological evaluation may be in order.

Common sense measures include avoiding acid food, checking for habits such as tongue thrusting and trying to drink lots of water.
Some prescription medications may help: A lozenge-type form of the anticonvulsant medication clonazepam (Klonopin), Alpha-lipoic acid, a strong antioxidant produced naturally by the body, oral thrush medications, some antidepressants (although they tend to dry the mouth), B vitamins (especially thiamin and B12), Saliva replacement products, lidocaine mouth rinses or gels. Paradoxically, capsaicin which produces a burning sensation (it is derived from cayenne pepper) may help. Finally, some have found some forms of psychotherapy helps. It is a medical axiom that if there is one good treatment, that’s the treatment of choice. If there is no one good treatment there are many treatments and, as you can tell from this list, there is no one good treatment.