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Burning mouth

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SYMPTOM

Burning mouth

As its name suggests, Burning Mouth Syndrome (or BMS for short) makes you feel like you’ve just burnt your mouth on a too-hot spoonful of soup or sip of tea — except you haven’t...it just feels that way (think burning, tender, tingling, hot, scalding, numb sensations). Never heard of it? You’re not alone. Officially known as glossodynia, BMS is relatively rare and, while it happens to be most common for perimenopausal and menopausal women, it is definitely not as widely recognized as symptoms like hot flashes and weight gain.

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    The science

    According to the American Academy of Oral Medicine, BMS occurs in just about 2% of the population, making it a relatively rare syndrome.

    Here’s the thing about BMS: when it comes to the science behind it, the jury’s still out. Doctors define it as “an intraoral burning sensation of idiopathic etiology occurring in the absence of identifiable oral lesion or laboratory findings,” which is essentially a souped-up way to say that your mouth burns for no identifiable reason or known cause.

    Although there isn’t a universally accepted definition, scientists do know that the incidence rises in women aged 40-60, which correlates with the timing of perimenopause and menopause, but does not prove cause and effect. Specifically, we’re talking about a relationship with a drop in estrogen/oestrogen levels, as well as other fluctuations between adrenal, reproductive, and neuroactive (i.e. brain) steroids that influence the excitability of neurons. Simply speaking, the major hormonal fluctuations of the menopausal transition may somehow make our nerve cells more sensitive — the sensation we feel as pain.  

    Other proposed causes include allergies, chronic stress/anxiety, depression, and nutritional deficiencies — all of which may be related in some way, shape, or form to fluctuating hormone levels in menopause.

    BMS symptoms generally come in packs of three.

    1. Mouth pain, which is commonly felt along the roof of the mouth, tongue, and lips and is exacerbated by the consumption of hot/spicy food, too much speaking, and stress
    2. Alteration in taste (aka dysgeusia), which is present in up to 70% of cases and leads to a bitter or metallic taste in your mouth
    3. Reduced saliva production, which causes a dry mouth feel

    The pain can be gradual and random or sudden and targeted to a specific event. Generally speaking, women find that the burning sensation is mild upon waking up, only to intensify with the first meal of the day and reach its max by late evening. For this reason, some women report that BMS makes it difficult for them to fall asleep and may cause them to wake up occasionally throughout the night.

    In cases of what’s called Secondary BMS, symptoms are caused by a specific, underlying medical condition — e.g., acid reflux, dry mouth, or a mouth infection — in which case your doctor will likely address that first. (Primary BMS, on the other hand, has no identifiable cause.)

    If you’re experiencing a painful, burning mouth and you also have vaginal pain, the cause could be an autoimmune disorder called lichen planus (lie-lun play-nus). Affecting approximately 2% of the entire population (but skewing towards menopausal and postmenopausal women 50+), lichen planus causes inflammation in the skin and mucous membranes, which can lead to chronic pain in the vagina and mouth.


    Learn More

    Guide to Burning Mouth Syndrome (Oral Health Foundation)
    Burning Mouth Syndrome symptoms, causes, & diagnosis (Mayo Clinic)

    What you can do

    We’re all about equipping you with the know-how to understand your symptoms, and we especially emphasize the specific, tangible ways to manage them. Our goal is to empower YOU to take charge of your menopause journey, starting today.

    A quick note about product recommendations…Elektra Health is not paid to feature any products. We just like them and think you might too, though we can’t guarantee any results.


    So we’ve got some good and *less great* news here. Unfortunately, the BMS treatments out there have all been studied for pain management only, not for curing the syndrome. While they’ve been found effective in at least one study, that one study is the only evidence we have, so it’s hard to make concrete recommendations without multiple studies to substantiate the findings.

    However…and here’s the better news…there’s a wide range of solutions that have been proposed, from nutritional to behavioral to medical, so you’re likely to find at least one that fits your lifestyle.


    Lifestyle & Over-the-Counter Solutions

    High fluid diet

    Drinking lots of liquids, and even sucking ice chips, can provide relief from sensations of burning and dryness.

    Limited consumption of hot beverages & spicy foods

    When it comes to foods and drinks that trigger or exacerbate the burning sensation, hot beverages and spicy foods top the list, so it’s best to limit them as much as possible.

    Toothpaste tailored to those with mouth sensitivities

    Monitor your symptoms after brushing your teeth. If burning worsens, consider swapping out your toothpaste for one specifically designed for people with mouth sensitivities, such as Sensodyne or Colgate Sensitive. Alternatively, try the baking soda trick. Just dissolve one spoonful in lukewarm water and rinse, rinse, rinse (then spit it out, don’t swallow). That should neutralize the acid and provide a soothing, calming sensation.

    Cognitive behavioral therapy (CBT)

    CBT refers to a specific type of psychotherapy (or talk therapy) that, in this case, is helpful in reassuring women suffering from BMS that, while uncomfortable, it is not fatal (or even harmful), nor is it permanent. Bonus points for the fact that CBT helps in stress management, which is associated with BMS.

    Alpha lipoic acid

    Some women have found alpha lipoic acid — an antioxidant produced naturally in the body that is also found in foods such as potatoes, spinach, and tomatoes — to be effective in easing pain from BMS when taken in supplement form. It works by promoting the production of nerve growth. The typical dose is 200 mg three times a day, taken for anywhere between 4 weeks to several months. 

    Capsaicin

    Counter-intuitive as it may sound, some women swish around mouthwashes made with hot pepper sauce diluted in water at a 1:2 ratio to ease BMS symptoms. The sauce, which contains a substance called capsaicin from hot peppers, is effective in desensitizing thermal stimuli, thus decreasing burning and pain.


    Prescription

    Hormone replacement therapy (HRT)

    Due to just how rare BMS is, it’s impossible to say whether HRT is an effective solution. Although there was a small study that showed improvement for half of the symptomatic women on HRT, the numbers are just too small to draw conclusions.

    For more on all things HRT, refer to our complete guide.

    Non-Hormonal

    Certain low-dose medications that ease neuroinflammation (inflammation of nervous system tissues in the brain and spine) have been found effective in regulating BMS pain, like gabapentin which is typically used to treat seizures and nerve pain. Antidepressants such as SSRIs and anti-anxiety medications such as Clonazepam may also help, as depression and anxiety are often associated with BMS. Of course, all medications come with side effects so it is important to weigh both pros and cons of each agent with your healthcare provider. 


    We’re always keeping an eye out on emerging research and the latest clinical studies. Subscribe to our weekly Elektra Digest for the latest, science-based info direct to your inbox. Something work well for you that’s not listed here? We want to hear it! Shoot us a note at [email protected]. (We’re human, promise.)


    Disclaimer: This information is for general educational purposes, and should not be used as a substitute for medical advice, diagnosis or treatment of any health condition or problem.

    As with anything you put into your body, taking dietary supplements can also involve health risks. You should consult a medical professional before taking supplements and inform your doctor about any supplements, as well as any medications you already take, since there may be interactions.

    References

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