Mouth Diseases - Burning Mouth Syndrome - Burning Mouth Syndrome Articles

Mouth Diseases
Burning Mouth Syndrome

Burning mouth syndrome is a fairly common but poorly understood condition that most frequently affects post-menopausal females. People affected by it experience abnormal sensations of the mouth (burning sensation of the tongue) as well as alterations in taste and mouth texture. The nerves of the mouth may become hyperirritable, and even normal, barely-notable sensations (like the tongue rubbing against the teeth) may seem painful or uncomfortable.
Cause

Although the cause of this disorder is not known, most of the evidence suggests that this is a minor (but annoying) problem with certain nerves (called sensory nerves) that supply information from the oral tissues, especially the tongue, roof of the mouth and lips, to the brain. This "misinformation" includes telling the brain that the mouth (especially the tongue) feels scalded ("burning" sensation), that bad tastes are present, or that the texture of the mouth is wrong (usually a "dry" feeling).

Much less frequently, burning tongue symptoms may be caused by oral yeast infection or certain rare types of anemia and these should be ruled out in order to make a diagnosis for burning mouth syndrome. If yeast infection of the mouth is suspected, it would have to be proven by doing a culture (swab) of the lining of the mouth. If yeast is present, the problem should be easily treated with antifungal medication.
Diagnosis

Diagnosis of this condition can sometimes pose a problem because despite the presence of symptoms, when the mouth is examined, everything appears normal. This causes a great deal of confusion for the doctor who is not familiar with this condition. The best person to evaluate this problem would be an oral and maxillofacial pathologist.
Treatment

There is no medically proven treatment for this condition, and none of the so-called "cures" for burning mouth have been shown to be any better than placebo ("sugar pill"). However, for about half of the people who get this problem, it goes away by itself after a period of time, although the amount of time varies from person to person and is unpredictable.

One thing that I recommend for my patients with burning mouth syndrome is a modified form of capsaicin therapy. Capsaicin, the "hot" in hot peppers, has been shown in laboratory animals to reduce the number of nerves close to the skin that carry pain (pain fibers). The drug form of capsaicin therapy (brand name Zostrix) has been used to treat people with severe chronic pain of the skin in conditions such as shingles (recurrent varicella zoster virus infection).

While this prescription medication is too strong for use in the mouth, a common product found in the grocery store can substitute nicely. Available in many brands, select any hot pepper sauce (I usually suggest a red chili pepper sauce since they are very common in the US). Dilute 3-5 drops of hot sauce in a teaspoon of water. Swish this mixture in the mouth for 45 seconds and spit it out.

If too hot, reduce the hot sauce. If hardly noticeable, you can increase the amount of hot sauce relative to the water. Use after meals and right before going to bed.

Since the dose is quite mild (relatively), changes in the sensations within the mouth will be slow. Many patients indicate that it takes 10-14 days before they feel improvement in their symptoms. You can continue to use this regimen as needed.
Hope

Use of hot sauce in this manner is not a cure but often gives a sense of control back to patients who, like yourself, have not previously been able to improve their symptoms. It also has the advantages of being inexpensive, having no drug interactions and virtually no other complication besides a transient "hot" feeling inside the mouth.

While it is an annoying condition, burning mouth syndrome typically is not progressive, does not represent a form of cancer, and cannot be transmitted to anyone else.

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Last Reviewed: Aug 15, 2008