Perplexing and painful, burning mouth syndrome (BMS) is a complex pain disorder causing a burning or scalding sensation in the mouth. While all areas may be affected, you may experience isolated burning sensations on one or more areas including the tongue, lips, gums, palate or throat. The pain and discomfort may appear suddenly or develop over time. (1)
Underlying medical conditions, including diabetes, allergies, dry mouth, yeast infections, acid reflux and certain thyroid problems are burning mouth syndrome causes. When medical tests can’t find an underlying medical problem, the diagnosis may be primary BMS. (2)
While researchers remain puzzled as to why and how symptoms can just arise spontaneously, the National Institute of Health’s online library of medical research studies and reviews currently has over 1,000 documents listed on the site that reference burning mouth syndrome. And, most encouragingly, clinicaltrials.gov, the clearing house for clinical trials in the US, currently contains 41 BMS studies in various stages of completion. (3)
For the tens of thousands suffering from burning mouth syndrome symptoms, take heed in the fact that physicians and researchers are taking your condition seriously. In fact, they are exploring a broad range of treatment options and looking for safe and effective treatments in prescription medications, natural therapies, home remedies and complementary medicine.
What is Burning Mouth Syndrome?
Burning mouth syndrome is broken into two diagnoses, primary BMS and secondary BMS. When medical tests do not determine that there is an underlying medical problem or prescription medication causing the symptoms, the physician will likely diagnose primary BMS. If, on the other hand, the symptoms are due to an underlying medical condition or prescribed medication, he or she will diagnose secondary BMS. (4)
Typically, your physician and dentist may order allergy tests, conduct oral swab tests, biopsy tissue, MRIs, CT scans or blood tests to assist in the diagnosis. Ear, nose and throat specialists, as well as dermatologists and gastroenterologists, may be consulted as well. In fact, there simply isn’t a single definitive test to determine if you have burning mouth syndrome; it is truly based on the pain and discomfort you experience. (5)
If your medical team determines that you have secondary BMS, treating the underlying medical causes of your symptoms can provide relief.
Burning mouth syndrome is considered a complex pain disorder that is both difficult to diagnose and difficult to successfully treat. It often appears spontaneously, with no known triggering factor. Burning mouth syndrome causes localized pain and discomfort, but also can cause difficulty eating, depression, anxiety, irritability and trouble sleeping.
Like many other chronic pain conditions, finding an effective burning mouth syndrome treatment can take time and persistence; no two people experience pain or relief in the same manner.
Signs & Symptoms
Burning mouth syndrome is a painful condition where the discomfort gets worse as the day progresses. Because of this, in some cases individuals affected may experience:
- Dry mouth
- Increased thirst
- Changes or loss of taste
- Metallic taste in mouth that remains after eating or brushing teeth
- Burning or scaled sensation in one or more areas of the mouth
If you have one of the known underlying medical causes of secondary BMS, symptoms may arise at any time during illness and treatment. Some common medical conditions that can cause burning mouth symptoms include: (6)
- Sjogren’s Syndrome
- Radiation therapy
- Low blood pressure medications
- Vitamin B deficiency
- Iron deficiency
- Acid reflux
- Thyroid problems
- Fungal infection in the mouth
- Dentures that don’t fit properly
- Allergic reactions to dyes, foods, toothpaste, fragrances or environmental elements
Risk factors for primary BMS include:
- Being female
- Over the age of 50
- Dry mouth
- A recent illness
- A recent traumatic life event
- Elevated stress levels
- Undiagnosed anxiety and depression
As indicated above, if your doctor diagnoses you with secondary BMS, it’s important to treat the underlying causes to provide relief. In the interim, your healthcare team may prescribe: (7)
- Painkillers specially formulated to block nerve pain
- Saliva replacement products
- Oral rinses
- Tricyclic Antidepressants like Elavil
- Cognitive behavioral therapy
- Sedatives like Klonopin
- Anticonvulsants like Neurontin
Many of the typical medications prescribed as a burning mouth treatment have the potential to cause moderate to severe side effects, and some can cause dry mouth. Talk to your healthcare provider about the possible side effects and what to expect by following conventional treatments.
9 Home Remedies for Burning Mouth Syndrome
- Capsaicin Rinse:
According to the American Family Physician’s article published on burning mouth syndrome, a capsaicin rinse can help to improve symptoms. (8) Yes, hot peppers may help relieve pain in those suffering from burning mouth syndrome! Several double-blind research studies indicate its safety and efficacy when a solution is applied orally. (9, 10,)
In fact, one of the studies found that symptoms improved in 80% of patients who were given capsaicin. (11) The ideal solution, according to various studies, is to start with a 1:2 ratio of hot peppers to water, building to a 1:1 ratio, or the highest concentration that is tolerable to the patient. It is believed that the capsaicin provides a numbing effect, relieving the pain and discomfort for several hours.
To make a capsaicin burning mouth syndrome home treatment, mix two teaspoons water with one teaspoon cayenne pepper extract. Swish around your mouth for 20–40 seconds, or whatever is tolerable, and then spit. Depending on what is tolerable, increase the strength bit by bit until the numbing action takes effect. Be sure to wash your hands thoroughly if any of the solution gets on your fingers.
- Vitamin B12
As mentioned above, one of the potential underlying causes of burning mouth syndrome is a deficiency in vitamin B12. In a study published in the Journal of Oral Pathology & Medicine, researchers indicated that vitamin B12 reduces abnormally high levels of homocysteine found in burning mouth syndrome patients and that 177 patients out of 399 total patients in the study showed complete remission of all oral symptoms after treatment. (12)
If you are experiencing symptoms of burning mouth and any signs of vitamin B12 deficiencies, boosting your intake of B12 is highly recommended. For adults, 2.4 micrograms to 2.8 micrograms daily are the RDA (recommended daily allowance) for B12. In addition to supplementation, adding vitamin B12-rich foods like beef and chicken liver, wild-caught salmon, mackerel, sardines, tuna, organic yogurt, turkey or raw milk can help boost your levels naturally. This burning mouth syndrome home remedy may take time to relieve the pain; the study above provided supplementation for patients for 4–8 months.
- Iron-Rich Foods
In addition to a vitamin B12 deficiency, iron deficiencies are also considered a burning mouth syndrome cause. (13) While iron supplements are available, I recommend boosting iron levels by increasing your consumption of healthy iron-rich foods. My top choices are:
- Organic beef liver
- Grass-fed beef
- Dark chocolate
- Black beans
Like a vitamin B12 or iron deficiency, zinc deficiencies have been linked to burning mouth syndrome. According to the Linus Pauling Institute’s Micronutrient Information Center, nearly 2 billion people worldwide have a marginal zinc deficiency. (14) Common signs of zinc deficiency include poor neurological function, weak immune system function, diarrhea, allergies, thinning hair, leaky gut and acne or rashes.
The RDA for zinc for adults 19 and over is 8mg for women and 11 mg for men. In addition to supplementation, adding zinc-rich foods to your diet can be helpful. This includes lamb, pumpkin seeds, grass-fed beef, chickpeas, cocoa powder, cashews, and kefir or yogurt. Try my Spicy Roasted Pumpkin Seeds recipe to add zinc and capsaicin to your diet as a one-two punch for burning mouth syndrome treatment.
- Baking Soda
Baking soda is one of the most inexpensive and versatile purchases you can make. For generations, it has been used to relieve digestive upset, as a natural deodorant, to ease the misery of poison ivy or poison oak, and to alleviate the pain of sunburns. All of this, in addition to its being a safe and effective cleaner in the home. Now, there is some anecdotal evidence from patients with burning mouth syndrome that baking soda helps to relieve the discomfort.
In order to relieve symptoms of burning mouth syndrome, mix 1/3 cup of warm water with 1 ½ teaspoons of baking soda together in a mug. Swirl the mixture around your mouth, and if the burning sensation is also in your throat, gargle. In addition, you might want to try a natural toothpaste that does not include the potentially harmful sodium lauryl sulfate, which is a known irritant. Try whipping up a batch of my homemade baking soda toothpaste that has coconut oil, baking soda, peppermint essential oil, and trace minerals.
- Mouth Rinse
In addition to the scalding pain that is common in burning mouth syndrome, many people struggle with a very dry mouth. Dry mouth can cause tooth decay, bad breath, chapped lips and other dental problems. To combat the dryness itself, and to protect yourself against the side effects of dry mouth, using an all-natural mouth rinse, or oil pulling, can provide some relief.
Some patients report that placing a ½ teaspoon of local, raw honey on your tongue and swishing it around will temporarily relieve the burning sensation. Dioscorides, a Greek physician, prescribed honey for sunburns and infected wounds as early as 50 A.D. to provide relief and spur healing. (15)
- Alpha Lipoic Acid
A study published in the journal Oral Medicine and Pathology found that 600 mg/day of alpha lipoic acid was effective in improving burning mouth syndrome symptoms. (16) While researchers haven’t identified how ALA helps relieve the symptoms, it is known to fight diabetes, preserve eye health, prevent memory loss, act as a powerful antioxidant, and help to protect the skin from sun damage.
In addition to using a high-quality natural ALA supplement, increasing your intake of foods rich in alpha lipoic acid can help. Try eating some of my favorite, healthy foods with high levels of ALA, which include: broccoli, spinach, carrots, Brussels sprouts, brewer’s yeast, tomatoes, peas, beets, grass-fed red meat and grass-fed organ meats.
- Stress-Relieving Activities
Stress, depression and anxiety are not only risk factors for burning mouth syndrome, but also are common after diagnosis. And for a good reason. Constant discomfort and pain take a dramatic toll on your psyche and overall mental health. Participating in regular aerobic exercise and activities, including yoga and guided meditation, can help reduce the stress load while you are searching for relief from the symptoms.
If you’ve been diagnosed with secondary BMS, be sure to seek treatment for the underlying conditions causing your burning mouth symptoms. If you’ve been diagnosed with primary BMS, potential complications include:
- Difficulty eating
- Weight loss
- Poor sleep quality
- Burning mouth syndrome can affect the lips, tongue, palate, gums, throat or the entire mouth, causing pain.
- Diagnosis is challenging as there is no definitive test.
- Secondary BMS is a diagnosis that indicates an underlying medical condition, such as Sjogren’s syndrome, some cancer treatments, or other conditions are causing the symptoms.
- Primary BMS is a diagnosis that indicates no underlying condition has been determined.
- Symptoms vary from moderate to severe and can build over time or appear spontaneously.
- Treatment is challenging as no two people experience the pain or relief in the same manner.
- Prescription medications typically prescribed can have potentially harmful side effects.
- Natural remedies may help to reduce the discomfort, pain, dry mouth and depression associated with burning mouth syndrome.
- Medical research points to the effectiveness of capsaicin rinses, treating nutritional deficiencies, honey, and alpha lipoic acid as burning mouth syndrome treatments.