Remedies for Burning Mouth Syndrome

Burning mouth syndrome (BMS) is a vexing and poorly understood medical condition. Burning pain affects the lips, tongue, and at times the entire mouth, often for no detectable reason. Sometimes called burning tongue syndrome, the disorder usually occurs in conjunction with yeast infections of the mouth commonly known as thrush or with xerostomia or dry mouth. Other names for the condition include scalded mouth syndrome, glossodynia, and stomatodynia.

Is That Why My Mouth Feels Scalded?

Women are more likely than men to suffer from BMS although it affects approximately four percent of adults in the United States. Usually striking in middle age, sufferers initially experience a burning, itchy, dry mouth. They describe the feeling as similar to that which occurs after consuming a hot liquid or food and scalding the mouth. In addition to the burning mouth sensation, patients describe numbness at the tip of the tongue and a bitter, metallic taste. For some, the pain disappears after a good night’s sleep and comes back during the day while in other cases the pain is constant.

What are the Causes of Burning Tongue?

More than a third of the people with BMS have multiple triggers for the condition but some common burning mouth syndrome causes include:

• dry mouth syndrome (xerostomia)
• oral conditions such a thrush
• psychological factors
• nutritional issues
• poorly fitting dentures
• nerve damage
• acid reflux disease
• medications
• repetitive oral habits
• endocrine disorders
• hormonal imbalances especially during menopause.

Dry mouth syndrome is caused by either the normal aging process or, most commonly, by medications like antidepressants or antihistamines. Hopefully, a change in prescriptions will alleviate both the dry mouth and the burning sensations, but all too often both conditions are difficult to pin down to any one factor and can be persistent.

Oral yeast infections, commonly lumped under the term “thrush,” occur when something disrupts the chemical balance of the body (often an autoimmune disorder like AIDS or as a consequence of cancer treatment) and the fungus Candida albicans grows out of control. This growth causes white lesions in the mouth and perhaps down the throat with burning pain in adults.

The psychological factors behind any condition like BMS are poorly understood at best. Stress and depression can bring on a burning mouth, but the “why” part of the equation is unclear. In some instances, the anxiety places stress on already damaged nerves (like those that control taste and pain in the mouth) and irritation results. Nerve damage can be caused by injury, by complications from a dental procedure, by poor diet, or by medications.

Nutritional issues include deficiencies in iron, zinc, B vitamins (1, 2, 6, and 12). A lack of these same nutrients can also lead to anemia. Also, food allergies, perhaps reactions to food coloring, fragrances, and other additives have been linked to burning mouth syndrome. Also, the acrid, bitter fluid that comes into the mouth from acid reflux disease may be a contributor as well.

Poorly fitting and maintained dentures can not only damage the surface of the mouth’s tissues from friction and rubbing but can also be a breeding ground for fungus and bacteria. Also be aware of repetitive oral habits like chewing the inside of the cheek, tongue thrusting, or teeth clenching.

Blood pressure medications (angiotensin-converting enzyme inhibitors), in particular, cause burning mouth. The high blood sugar present in diabetes can be responsible for BMS as can the hormonal imbalances of menopause that plague women. The belief is that the fluctuations in hormones and the resulting change in the chemistry of the saliva cause inflammation in the mouth.

What Happens if They Can’t Find a Specific Cause?

Most likely if your doctor cannot figure out what’s going on with your mouth, you will be put on an antidepressant. This may not be the best solution for you as these medications can make the condition worse and carry other side effects. Any time your doctor gives you a prescription find out everything you can about the drug before you start taking it. If you’re not comfortable with the medication, get a second opinion.

Even in the absence of a confirmed diagnosis of thrush, your burning mouth may be treated as a fungal infection. Be aware that fungicides can damage the liver and should not be used long term. Many people prefer to take the appropriate supplements and to use various coping measures like avoiding acidic drinks and cigarettes.

BMS Treatment – Baking Soda

For some, sugar-free gums and chewing on or sucking ice chips provides temporary relief. Also, use baking soda to brush your teeth instead of commercial toothpaste. You may want to visit a good quality health food store to investigate herbal remedies for burning mouth or the use of alpha lipoic acid as an aid. (If you have stomach or digestive problems always discuss this with a nutritional or herbal consultant.)

How Is Burning Mouth or Burning Tongue Syndrome Diagnosed

When you seek the help of a doctor, you will receive an oral exam and will need to describe your oral habits and care routine – right down to the strength of the bristles on your toothbrush, so be prepared.

Most likely the doctor will want to take a complete blood cell count to look for infections or anemia. The blood will also be checked for nutritional deficiencies and mouth for diabetes. In many cases, a full round of allergy tests is also administered. If the doctor suspects thrush is the cause of your burning mouth syndrome, expect an oral swab to determine which fungus is growing out of control.

As daunting as it may sound, since BMS is so hard to pin to any one condition, you may, in the course of your diagnosis, see any one or all of the following medical professionals: a dermatologist, dentist, psychiatrist, psychologist, or an ENT (ear, nose, and throat.)

What Treatments Are Available?

The treatment of burning tongue syndrome is highly individualistic. If your burning mouth is associated with dry mouth which is in turn linked to a specific medication, merely changing the prescription may be the only solution necessary. For nutritional deficiencies, supplements can be used. An outbreak of thrush responds to oral antifungals such as Mycostatin or Diflucan. If it’s your dentures, you can improve your care regimen or have the appliance adjusted.

Unfortunately, however, these kinds of easy fixes only work in a few cases. Psychological conditions involving stress and anxiety can respond to antidepressants, but antidepressants contribute to dry mouth, and dry mouth adds to burning mouth. Many times people who have a burning mouth as a result of a psychological problem may face outbreaks of the condition throughout their lifetime.

Essentially, treating burning mouth syndrome involves identifying an underlying cause and addressing it to remove the BMS sensations. This is never an easy task because all too often it is impossible to figure out what is causing the oral inflammation.

When Should I Talk to a Doctor?

A good rule of thumb with any condition is to seek the advice of a physician when the irritation does not respond to home remedies or to the simple passage of time. If the problem continues after several days and you are dealing with persistent pain, soreness, and irritation of the gums a doctor should evaluate your symptoms.

How Can I Prevent Burning Mouth?

In general, you should avoid any irritation to the tissues in the mouth. This can include obsessive brushing of the teeth and the overuse of mouthwash. Also, avoid drinks with high acid content. Quit smoking. Unfortunately, an outbreak of burning mouth may be entirely beyond your control.

In the absence of an identifiable and treatable underlying condition, it is all too often true that someone suffering from a persistent case of burning mouth syndrome (also known as burning tongue syndrome) may have to learn to live with the condition.