Burning mouth syndrome - What treatments work?
What treatments work?
BMJ Group, Thursday 5 February 2009 00.00 GMT
There's no definite cure for burning mouth syndrome. That's because no one knows exactly what causes it. You may feel better once you know your pain isn't a sign of a serious disease. If you stop worrying about the pain, you might stop noticing it so much. But there are some treatments that may be worth trying.
Talking treatment
Cognitive behaviour therapy (CBT) is the treatment that's most likely to help.
CBT is a talking treatment (psychotherapy) that is often used for anxiety and depression. It might seem odd to have a talking treatment for your physical symptoms. But research shows CBT can help you cope better with pain. It may reduce the burning feeling, or make it go away altogether.
In CBT, you work with a therapist to make your thinking and behaviour more positive. You'll probably see the therapist once a week, for between six to 12 weeks. Each session will be about an hour long. Your doctor may refer you to a therapist, but there could be a waiting list for treatment.
Medicines
Medicines are not often used for burning mouth syndrome. When they are used, they are only available with a prescription from your doctor.
Antidepressants are usually used to treat depression, but some types are known to help with nerve pain. But there's no reliable research to show they work for burning mouth syndrome. Antidepressants can cause side effects, including drowsiness, a dry mouth, shaking, constipation and stomach upsets.
Burning mouth syndrome is more common in women who have reached the menopause. So doctors have looked at whether hormone replacement therapy (HRT) might help. One type of HRT called tibolone (brand name Livial), might help some women with burning mouth syndrome. But there hasn't been enough research to be sure. Tibolone may slightly increase the risk of breast cancer, although not as much as other types of HRT.
Clonazepam (brand name Rivotril) is usually used to treat epilepsy. Some research shows that sucking a clonazepam tablet might reduce the pain in people with burning mouth syndrome. But clonazepam can have serious side effects, including drowsiness, dizziness, poor concentration and confusion. It can also be addictive. It isn't often used for burning mouth syndrome in the UK.
Things you can do for yourself
You could try a painkilling mouthwash called benzydamine (brand names Difflam Oral Rinse and Difflam Sore Throat Rinse). You can buy it from a pharmacy. But there hasn't been enough research to say whether benzydamine mouthwash works. You may find it stings your mouth. If this happens, you can dilute it to half mouthwash and half water.
Alpha-lipoic acid (sometimes called ALA) is a food supplement sold by health food shops. There is a theory that it protects the nervous system. It might help people with burning mouth syndrome, but there hasn't been enough research to be sure.
© BMJ Publishing Group Limited ("BMJ Group") 2009
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