Mayo Clinic: Many medical conditions can cause a burning sensation in the mouth

DEAR MAYO CLINIC: My father, who’s in his 70s, went to his dentist with mouth pain and was told he has burning mouth syndrome and that there’s no known treatment. Could something else be causing his symptoms? Are there things he can do to ease the pain?

ANSWER: Burning mouth syndrome is defined as a persistent feeling of burning in the mouth not caused by mouth abnormalities or other health issues. A thorough evaluation can help determine if another underlying medical condition or a medication might be the source of the burning sensation.

Some of the most common culprits are thyroid problems, vitamin deficiencies — especially vitamin B — and an 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’s 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 of being 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’s no cure for this disorder, a variety of treatments may reduce your father’s symptoms and make the condition easier to handle.

Physicians who 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 a referral.

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.

Your father should avoid spicy foods and carbonated beverages, which can make burning mouth worse. Acidic foods may also aggravate his symptoms. These include foods that are tomato- 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, a prescription medication may help with burning mouth syndrome. Options include topical medications used just in the mouth, as well as medications taken in pill form.

Third, cognitive behavioral therapy can be quite useful for people with burning mouth syndrome and other painful chronic conditions. 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 some discomfort.

The bottom line is that your father does not simply have to accept the pain. A specialist can work with him to investigate an underlying cause and, if none is found, 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.

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