From the Guidelines
Burning mouth syndrome in postmenopausal women should be treated with gabapentin, high potency topical steroids, or viscous lidocaine, as these options have shown promise in reducing symptoms, particularly in moderate to severe cases, as per the most recent guidelines 1.
Treatment Approach
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 and addressing these factors may suffice, but for moderate to severe cases, specific treatments are recommended.
Recommended Treatments
- Gabapentin: This anticonvulsant has been evaluated in the context of a randomized, double-blind, placebo-controlled trial and found to reduce burning sensation in some patients 1.
- High potency topical steroids: These can be used in the form of gels or dental pastes and are preferred for their direct application to the affected area.
- Viscous lidocaine: This provides topical relief and can be used as part of the management strategy for oral dysesthesia.
Additional Considerations
- Dietary modifications: Patients should be advised on dietary changes to manage their symptoms, including avoiding irritants.
- Holding immunotherapy: In cases where burning mouth syndrome is related to immunotherapy, holding the treatment may be necessary, especially for moderate to severe cases.
- Multidisciplinary approach: Given the complexity of burning mouth syndrome, a multidisciplinary team approach, including dental and medical professionals, may be beneficial for comprehensive management. The approach to treating burning mouth syndrome should prioritize the reduction of symptoms and improvement of quality of life, considering the most recent and highest quality evidence available 1.
From the Research
Treatment Options for Burning Mouth Syndrome in Postmenopausal Women
- The treatment for burning mouth syndrome in postmenopausal women may include various interventions such as anaesthetics (local), antidepressants, benzodiazepines (topical clonazepam), benzydamine hydrochloride, cognitive behavioural therapy (CBT), dietary supplements, and hormone replacement therapy (HRT) 2, 3.
- Alpha-lipoic acid (ALA), gabapentin, and psychotherapy may provide modest relief of pain in burning mouth syndrome, with gabapentin potentially boosting the effect of ALA 4.
- Topical clonazepam has shown best evidence for efficacy in treating burning mouth syndrome 5.
- Other treatments that may be effective include Catuama and bupivacaine, although more research is needed to confirm their efficacy 4.
- Hormonal substitution, dopaminergic medications, and therapeutic non-invasive neuromodulation may provide efficient mechanism-based treatments for burning mouth syndrome in the future 5.
Interventions with Limited Evidence
- Capsaicin may be limited by its side effects, although it has shown some potential for decreasing pain/burning in burning mouth syndrome 4.
- Vitamins, benzydamine hydrochloride, olive oil, trazodone, urea, and Hypericum perforatum have been studied as potential treatments, but more research is needed to determine their efficacy 4.