a middle-aged woman sitting on a couch, holding her jaw and grimacing

DEAR MAYO CLINIC: I’ve had what I think is burning mouth syndrome for about two months and it’s getting worse, not better. Are there any at-home treatments that will make it less uncomfortable?

ANSWER: Before you try any treatments, I recommend you first get a thorough evaluation from a health care provider who is familiar with burning mouth syndrome. It’s important to rule out underlying medical conditions that could be contributing to your symptoms. Then, if the condition truly is burning mouth syndrome, a wide variety of treatment options are available, including self-care steps that may reduce discomfort.

Burning mouth syndrome
is a persistent feeling of burning in the mouth that is not due to mouth
abnormalities or other health issues. About 2% of the population is affected by
it. The burning sensation often is felt on the tip, sides and top of the
tongue; the roof of the mouth; and the inside of the lips. However, it may
occur anywhere in the mouth. It also can cause you to experience a bitter or
metallic taste, as well as tingling, stinging or numbness. These symptoms may
come and go, increase gradually as the day wears on, or be constant. Some
people have the feeling of dry mouth.

Burning mouth
syndrome that can’t be linked to an underlying medical condition is referred to
as primary burning mouth syndrome. This is thought to be caused by dysfunction
of the nerves that control pain and taste. Secondary burning mouth syndrome means
your health care provider has found an underlying cause of your discomfort.

Some of the potential triggers of burning mouth syndrome include hormonal changes, dry mouth, and nutritional deficiencies — especially vitamin B deficiency. But it also can be caused by gastroesophageal reflux disease; allergies; or reactions to foods, flavorings, fragrances or dyes. Psychological factors, such as anxiety, depression or stress, and some oral habits, such as tongue thrusting, biting the tip of your tongue and grinding your teeth, also can contribute to discomfort.

Many medications
can cause dry mouth. That, in turn, can lead to a burning feeling. For example,
dry mouth is often a side effect of antihistamines, diuretics and tricyclics.
If a medication is suspected to be the cause of your symptoms, your health care
provider may be able to recommend an alternative.

If you have secondary burning mouth syndrome, treating the
underlying cause should eliminate or at least greatly reduce symptoms.
Effectively treating primary burning mouth syndrome is more complicated.
Research has yet to prove or disprove the effectiveness of available
treatments. Still, that doesn’t mean these treatments can’t provide relief.

Although there is
no cure for burning mouth syndrome, there are treatments that may reduce your
symptoms and make the condition easier to handle. First, you can try a number
of self-care steps at home. They include using mild toothpaste, sipping water
throughout the day, chewing sugarless gum, sucking on sugarless candy and
avoiding mouthwash. You also may want to try over-the-counter products intended
for dry mouth relief, as they also can help ease burning mouth syndrome.

In addition, you
should avoid spicy foods and carbonated beverages. They can make burning mouth syndrome
worse. Acidic foods also may aggravate your symptoms. These include foods that
are tomato-based or vinegar-based, as well as citrus fruits and foods that
contain citric acid. Some people with burning mouth syndrome find it helpful to
avoid chocolate, too.

Your health care
provider also may recommend a prescription medication that may help with
burning mouth syndrome. Options include topical medications that are used just
in the mouth, as well as medications taken in pill form. Both can help with
pain relief.

An approach to managing painful chronic conditions called cognitive behavioral therapy can be useful for people with burning mouth syndrome. This involves working with pain management specialists to learn techniques that help make daily pain less disruptive.

Although symptom improvement may be gradual, one-half to two-thirds of people with burning mouth syndrome notice at least some improvement in their symptoms within a few months of treatment. Work with your health care provider, who can help you develop a treatment plan to minimize your symptoms and control burning mouth syndrome. — Dr. Rochelle Torgerson, Dermatology, Mayo Clinic, Rochester, Minnesota

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