Pain at Midlife - Burning Mouth Syndrome & Menopause Treatment

Pain at Midlife

Burning Mouth Syndrome

Burning mouth syndrome is defined as burning or painful sensations in an oral cavity with a normal mucosa. Many authors consider it a distinct clinical entity because of its characteristic epidemiology and its homogeneous and peculiar clinical features. Ninety percent of patients with burning mouth syndrome are postmenopausal women.[56] Occurrence of the syndrome is greatest from 3 years prior to menopause up to 12 years after. Patients most often awake without pain but have increasing symptoms as the day progresses. There is an association with several conditions, including personality changes (anxiety or depression being the most common); type II diabetes; possible nutritional deficiencies of B vitamins and zinc; and cranial nerve dysfunction.[56] Case reports have linked burning mouth syndrome to the use of ACE inhibitors.[57]

Treatments are usually directed at symptoms and include benzodiazepines (low-dose clonazepam), tricyclic antidepressants (Elavil), anticonvulsants (Neurontin), and local desensitization with topical capsaicin (hot pepper). For the latter, the patient rinses her mouth with 1 teaspoon of a 1:2 dilution (or higher) of hot pepper and water, increasing the strength as tolerated to a maximum of 1:1 dilution.[56]

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