Burning mouth syndrome is a relatively common but mysterious ailment that chiefly affects women around and after menopause. The good news is that although the condition is painful – the mouth feels as though it has been scalded, even though it looks normal – it is treatable and not contagious.
In what are called “secondary” cases, burning mouth is linked to problems such as diabetes, vitamin deficiencies, fungal infections, and medications such as ACE inhibitors, used to treat hypertension, says Dr. Vikki Noonan, an associate professor of oral and maxillofacial pathology at the Boston University School of Dental Medicine. Treating the underlying problem often gets rid of this type of “burning mouth” syndrome.
In other “primary” cases, burning mouth syndrome occurs by itself and is a type of neuropathic pain, caused by injury or malfunction of pain nerves. It is most common in older women who also have psychological distress – anxiety, depression, post-traumatic stress, or obsessive-compulsive disorder, says Dr. Sook-Bin Woo, an associate professor at the Harvard School of Dental Medicine.
“These women are usually very sad or anxious,” she says. “We always acknowledge that the pain is real, but that it is a symptom of a deeper problem.”
Treatment usually begins with over-the-counter supplements of alpha lipoic acid, an antioxidant. If this doesn’t help, try mixing a few drops of Tabasco sauce and water and sloshing it around your mouth. (Alternatively, you can use capsaicin, another hot pepper-based substance, available by prescription.) The idea is to deplete the body’s supplies of the pain molecule, substance P.
If that’s not enough, medications such as Klonopin or Elavil, taken in lower doses than for anxiety or depression, are sometimes prescribed. Stress management and psychotherapy can also be helpful.