DEAR MAYO CLINIC: My father, who is in his 70s, went to his dentist with mouth pain and was told he has burning mouth syndrome and that there is no known treatment. Could something else be causing his symptoms? Are there things he can do to relieve the pain somewhat?
ANSWER: It is possible that something else could be causing your father’s symptoms. A thorough evaluation can help determine if another underlying medical condition or a medication may be the source of the burning sensation. If your father does have burning mouth syndrome, a variety of treatment options are available to manage it.
Burning mouth syndrome is defined as a persistent feeling of burning in the mouth that is not due to mouth abnormalities or other health issues. That means your father needs a medical assessment to exclude other possible causes before he can be diagnosed with burning mouth syndrome.
Physicians that diagnose and treat burning mouth syndrome come from several medical specialties, including neurology, dermatology, and otorhinolaryngology or ENT. In some cases, oral surgeons or periodontists provide care for burning mouth syndrome. To find the right specialist for your father, contact his primary care physician for guidance on who to see in your community.
Many medical conditions can cause a feeling of burning in the mouth. Some of the most common culprits include thyroid problems, vitamin deficiencies — especially vitamin B deficiency — and iron deficiency. A specialist can review your father’s symptoms and medical history, do a physical exam and, if necessary, run laboratory tests to investigate possible causes.
Your father should also review with his doctor any medications he is taking. 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 father’s symptoms, the doctor may be able to recommend an alternative.
If after a careful evaluation no clear cause is found, then a diagnosis of burning mouth syndrome can be made. Although there is no cure for this disorder, there are a variety of treatments that may reduce your father’s symptoms and make the condition easier to handle.
First, he 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. He also may want to try over-the-counter products intended for dry mouth relief, as they also can help ease burning mouth syndrome.
Your father should avoid spicy foods and carbonated beverages. They can make burning mouth worse. Acidic foods may also aggravate his symptoms. Those include foods that are tomato-based or vinegar-based, as well as citrus fruits and foods that contain citrus acid. Some people with burning mouth syndrome find it helpful to avoid chocolate, too.
Second, your father’s doctor 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.
Third, an approach to managing painful chronic conditions called cognitive behavioral therapy can be quite useful for people with burning mouth syndrome. This therapy involves working with pain management specialists to learn techniques that help make daily pain less disruptive. It often allows people with conditions such as burning mouth syndrome to go about their normal activities, despite the presence of some discomfort.
The bottom line is that your father does not simply have to accept the pain of burning mouth syndrome. A physician who specializes in this disorder can work with him to investigate an underlying cause and, if none is found, he or she can help your father develop a treatment plan to minimize his symptoms and control burning mouth syndrome. — Rochelle Torgerson, M.D., Ph.D., Dermatology, Mayo Clinic, Rochester, Minn.