Burning mouth syndrome is a sensation of burning or irritation in the tongue and lining of the mouth that persists for weeks or months. For some people, it is severe enough to affect quality of life

Burning mouth syndrome can happen spontaneously or following:

  1. oral health problems like candidiasis (thrush), lichen planus, aphthous ulcers;
  2. tooth and gum disease, new dentures;
  3. whole body illness like thyroid, liver, autoimmune diseases and diabetes;
  4. gastro-oesophageal reflux;
  5. nutritional deficiencies;
  6. And is more common in people with dentures.

Symptoms vary in severity over time. Symptoms can be worse when:

  1. the mouth is dry: not drinking enough water, side effect of tablets for other problems or salivary gland disease;
  2. exposed to irritants: very hot or very cold food and drink, spicy foods, rough foods, alcohol, smoking, some mouth washes, lozenges, chewing gum;
  3. You are tired, worried, stressed or distressed.

Burning mouth syndrome is assessed by:

  1. Examination of the ears, nose, mouth and neck;
  2. Biopsies of the lining of the mouth or the salivary glands in the lip;
  3. Blood tests for diabetes, thyroid, liver and kidney function, Iron, B12, folate and auto-immune disease;
  4. Your dentist can check the teeth, gums and jaw.

To reduce symptoms:

  1. Avoid things that irritate the lining of the mouth: hard lollies, chips, crusty bread, alcohol, cigarettes, chili, very hot and very cold food and drink, lozenges and mouth washes containing alcohol, menthol or eucalyptus;
  2. Try a low irritant toothpaste like Alfree, Biotene or Dentamed;
  3. Eat and drink regularly to prevent dry mouth. Eat vegetables and fruit every day and make water your main drink;
  4. Treat any underlying causes found on biopsy and blood tests;
  5. Quit smoking;
  6. Learn techniques to manage stress (exercise, relaxation, meditation) or have treatment with your GP and psychologist for anxiety and depression if this is affecting you.

If burning mouth sensation persists and is severely reducing your quality of life or disrupting sleep, we can consider medications to reduce the sensation. These medications act on the sensory nerves from the mouth to the brain and are similar to medications used for chronic pain. They can have significant side effects including drowsiness and dry mouth. Starting with simple measures to reduce symptoms first is best.

Dry mouth (xerostomia)

Dry mouth can happen at the same time as burning mouth syndrome. It’s more likely in older people, people with diabetes or autoimmune disease and can be a side effect of medications or treatment for cancer.

To reduce dry mouth:

  1. Don’t smoke;
  2. Don’t do intermittent fasting or skip meals. Eat a diet high in fruit and vegetables and low in processed food and make water your main drink;
  3. Drink enough water for the mouth to feel moist, more on hot days and one extra glass of water for every caffeinated drink (tea, coffee, cola);
  4. Ask your doctor or pharmacist for advice about medicines you are taking that can cause dry mouth;
  5. Brush your teeth and gums with a soft toothbrush (or electric toothbrush) for 2 minutes twice a day and floss twice a day. See your dentist regularly. Dry mouth can increase teeth and gum problems. Your dentist may recommend a fluoride mouthwash used twice a day to protect your teeth;
  6. Chew sugarless gum to promote saliva flow;
  7. Use lip balm for dry lips and saliva substitutes for dry mouth (Biotene, Aquae), available over the counter at your pharmacy.

Halitosis or bad breath

There are many causes of halitosis, including

  1. What you eat and drink,
  2. How you care for your mouth and teeth,
  3. Tooth and gum disease,
  4. Other health problems.

Managing halitosis starts with

  1. A check up with your dentist,
  2. Promote healthy saliva:
    • quit smoking,
    • Make water your main drink, drink enough water to avoid dry mouth,
    • Eat a diet high in vegetables, fruit and whole grains and low in processed and odourant (smelly) foods,
    • Eat and drink regularly, avoid prolonged fasting,
    • Avoid alcohol, coffee and sugary drinks.
  3. Daily dental care:
    • Brush your teeth with a soft toothbrush twice a day for 2 minutes. Use an electric toothbrush if needed,
    • Floss at least once a day,
    • Mouth washes are optional. Ask your dentist for advice.

If halitosis persists, your doctor may check for:

  1. Dry mouth and causes of dry mouth including medications andblocked nose,
  2. Tonsil and throat problems,
  3. Diabetes,
  4. Liver, thyroid and kidney disease.