Burning Mouth Syndrome / Altered Taste (Menopause-Related)
Burning Mouth Syndrome (BMS) involves a burning, tingling, or scalding sensation in the mouth, often affecting the tongue, lips, or palate, despite no visible signs. It can be accompanied by dry mouth or altered taste (dysgeusia), such as a metallic or bitter taste. While the exact cause is often unclear, BMS prevalence increases around menopause, suggesting hormonal changes (particularly estrogen decline affecting nerve function or saliva production) may play a role. Other potential contributors include nutritional deficiencies, dry mouth, acid reflux, nerve issues, and psychological factors. Diagnosis involves ruling out other conditions.
Management Strategies
- Topical therapies (e.g., capsaicin rinse - use with caution)
- Medications sometimes used for neuropathic pain (e.g., alpha-lipoic acid, clonazepam - low dose dissolving tablet, certain antidepressants like amitriptyline) - consult specialist
- Cognitive Behavioral Therapy (CBT)
- Sipping cool drinks
- Sucking on ice chips
- Avoiding irritating substances (hot/spicy foods, acidic foods/drinks, alcohol, tobacco, harsh mouthwashes)
- Stress management
- Treating dry mouth (sipping water, sugar-free gum/candy, saliva substitutes, medications)
- Correcting nutritional deficiencies
- Managing acid reflux
- Treating oral infections
- Adjusting medications if implicated (consult doctor)
- Managing underlying medical conditions
Impact
- Discomfort
- Difficulty eating
- Anxiety
- Reduced enjoyment of food
Diagnostic Considerations
Diagnosis of exclusion. Requires thorough medical/dental history, oral exam, potentially blood tests (for deficiencies, diabetes, thyroid), allergy testing, salivary flow measurement. Rule out visible oral lesions.