From the Guidelines
Burning mouth syndrome treatment should prioritize gabapentin, high potency topical steroids, or viscous lidocaine for moderate to severe cases, as recommended by the most recent guidelines 1. When managing burning mouth syndrome, it's essential to assess the location and character of pain, rule out odontogenic or mucosal sources, and evaluate the severity of pain and its impact on function. For mild cases, assessing the location and character of pain, ruling out odontogenic or mucosal sources, and evaluating the severity of pain and its impact on function are crucial steps 1.
- Key considerations in treatment include:
- Holding immunotherapy for moderate to severe cases
- Dietary modifications
- Use of gabapentin, high potency topical steroids (gel or dental paste preferred), or viscous lidocaine
- The condition often requires a multidisciplinary approach, considering factors such as nerve damage, hormonal changes, dry mouth, or nutritional deficiencies, as noted in other studies 1.
- Cognitive behavioral therapy can be beneficial for addressing psychological factors associated with burning mouth syndrome, as it is often linked with depression and poor quality of life 1.
- Treatment typically requires a trial-and-error approach, and most patients need to try several approaches before finding effective symptom relief, which may need to continue long-term as the condition can be chronic.
From the Research
Treatment Options for Burning Mouth Syndrome
The treatment options for burning mouth syndrome (BMS) can be categorized into several approaches, including:
- Local and systemic treatments to address underlying causes
- Pharmacological therapies to manage symptoms
- Alternative therapies to provide relief
Pharmacological Therapies
Pharmacological therapies have been found to be effective in managing BMS symptoms, including:
- Capsaicin, which has been shown to provide relief of oral burning or pain symptom 2
- Alpha-lipoic acid, which has been found to be effective in reducing oral burning or pain symptom 2, 3
- Clonazepam, which has been shown to be effective in reducing burning pain intensity in BMS patients 4, 3, 5
- Antidepressants, which have been found to be effective in managing BMS symptoms 2
- Pregabalin, which has been found to be effective in reducing BMS symptoms in some patients 6
Alternative Therapies
Alternative therapies have also been found to be effective in managing BMS symptoms, including:
- Psychotherapy and behavioral feedback, which can help eliminate BMS symptoms 2
- Cognitive behavior therapy, which has been found to be effective in both short- and long-term assessment 3
- Low-level laser therapy, which has been found to be effective in both short- and long-term assessment 3
- Topical capsaicin, which has been found to be effective in both short- and long-term assessment 3
Treatment Approach
The treatment approach for BMS typically involves a step-wise approach, starting with the removal of potential causes, followed by pharmacological therapies, and finally alternative therapies. Vitamin, zinc, or hormone replacement therapy may be effective for reducing oral burning or pain symptom in some BMS patients with deficiency of the corresponding factor 2.