Burning Mouth Syndrome

Geriatric Essentials

• Burning mouth syndrome is most common among postmenopausal women.

Burning mouth syndrome is an idiopathic chronic pain disorder characterized by an intermittent or constant burning sensation in the mouth (stomatopyrosis), tongue (glossopyrosis), or both. It is most common among postmenopausal women. Proposed causes include ill-fitting dentures; deficiencies of B-complex vitamins (eg, B₁, B₂, B₆, B₁₂), iron, or folic acid; local trauma; GI disorders; allergies; salivary hypofunction; and diabetes. There may be an association with anxiety or depression in some patients.

Diagnosis is by exclusion; any identifiable oral lesion precludes the diagnosis. Treatment can be challenging and frustrating, but antidepressants (eg, nortriptyline) or benzodiazepines (eg, clonazepam) given in low doses in the morning or at bedtime are often beneficial. See also the Cochrane review abstract on interventions for the treatment of burning mouth syndrome. Spontaneous remissions are not uncommon, but exacerbations may occur.

This topic was last updated September 2005.