An expert guide to burning mouth syndrome

Hot flashes, mood swings and sleep problems are common as a woman approaches and passes menopause. Much less common but as disruptive is another condition that can afflict perimenopausal and postmenopausal women: burning mouth syndrome.

“Burning mouth syndrome can affect swallowing, eating, speech and sleep,” says Dr Sarmed Sami, a gastroenterologist at Mayo Clinic Healthcare in London. “There’s a lot more to it than your mouth feeling uncomfortable. In addition to affecting your quality of life, it can affect various aspects of your health.”

Burning mouth syndrome can include a burning feeling in the tongue, lips, gums, throat or roof of the mouth. Other symptoms may be thirst, a dry mouth, a bitter or metallic taste, loss of taste, and mouth tingling, stinging or numbness. The frequency of symptoms can vary widely, from all day every day to sporadic. 

Dr Sarmed Sami of Mayo Clinic Healthcare

Treatment involves addressing both the symptoms and the cause, Dr Sami says. For example, if the burning mouth syndrome is likely related to menopause, hormone replacement therapy (HRT) may help. Other potential underlying conditions include gastro-oesophageal reflux, thyroid problems, vitamin deficiencies, and irritation from toothpaste, mouthwash or acidic foods and beverages. The cause cannot always be identified.

“We use medications to essentially calm down the nerves and sensors in the mouth, because we think there is hypersensitivity,” Dr Sami says. “Stress can also cause it, so we may use complementary therapies such as acupuncture.”

One unlikely sounding option is to fight fire with fire: the use of hot pepper sauce as a therapy for burning mouth syndrome. “There are certain chemicals that help reduce sensitivity. Hot sauce may seem counterintuitive, but it contains capsaicin, which can help relieve burning pain in nerves,” Dr Sami says.

Factors that put people at the highest risk for burning mouth include being female, perimenopausal or postmenopausal, over 50 and smoking. Secondary factors that can raise risk include:

— Recent illness
— Medical conditions such as fibromyalgia, Parkinson’s disease, autoimmune diseases and neuropathy
— Dental work
— Food allergies
— Some medicines
— Stress, anxiety, depression and traumatic life events

In addition to medical treatment, burning mouth symptoms may be eased by lifestyle changes and other self-help measures. Those include drinking plenty of liquids, sucking on ice chips, avoiding alcohol, avoiding spicy foods, refraining from tobacco use, avoiding products containing cinnamon or mint, and using mild or flavour-free toothpastes, and avoiding acidic foods and liquids such as tomatoes, orange juice, carbonated beverages and coffee. Working to reduce stress and relax can also help.