Burning mouth syndrome is characterized by intense burning pain in the mouth, often affecting the tongue and lips. Patients say it feels as if they’ve scalded their mouths by drinking something too hot. No one knows the cause, but the syndrome has been associated with menopause, oral thrush, dry mouth (xerostomia), nutritional deficiencies, and psychological problems including anxiety and depression (burning mouth may cause emotional upset or result from it). It most commonly occurs among postmenopausal women, perhaps because of the effects of hormonal changes on the composition of saliva.
Burning mouth can be a side effect of such medications as tricyclic antidepressants, lithium, diuretics and drugs to treat high blood pressure. It can also result from the autoimmune disorder Sjogren’s syndrome and from the aging process. Oral thrush is a yeast infection that can be associated with depressed immunity, denture use, diabetes, and some medications. Deficiencies of iron, zinc and B vitamins have been linked to burning mouth syndrome, as have such physical problems as nerve damage, allergies, gastroesophageal reflux, teeth grinding, hypothyroidism, and irritation of oral tissues from overuse of mouthwash. Drinking too many acidic drinks or brushing the tongue too often or too hard can also cause it.
If any of the disorders linked to burning mouth syndrome turns out to be the cause, dealing with the underlying problem is the best treatment. I also recommend trying hypnotherapy, DGL (deglycyrrhizinated licorice), available as chewable tablets, wafers, capsules, tea and powder. Follow the dosing instructions on the product. Another natural remedy that helps heal irritated oral tissues is slippery elm (Ulmus rubra) in the form of lozenges, which you can take as needed to soothe pain. You will find them in most drug stores.
Andrew Weil, M.D.