Alternative treatments for burning mouth syndrome
Burning Mouth Syndrome (BMS) is a condition characterized by chronic pain in the tongue and mouth, often accompanied by dry mouth and altered taste sensations. The cause of BMS remains unclear, but it is believed to involve altered nerve function. While conventional treatments typically include medications for neuropathic pain, alternative approaches are also explored. One principal proposed treatment is alpha-lipoic acid, although research on its effectiveness has yielded mixed results. Other alternative treatments suggested for BMS include St. John's wort, antifungal treatments for yeast hypersensitivity, and supplementation with vitamins B1, B2, B6, and zinc, though evidence supporting their efficacy is lacking. Additionally, capsaicin, acupuncture, and lifestyle modifications such as stress management and dietary changes are recommended. Patients are advised to avoid irritants like tobacco and spicy foods. Overall, the treatment landscape for BMS remains complex, and individuals are encouraged to seek professional guidance when considering alternative therapies.
Alternative treatments for burning mouth syndrome
DEFINITION: Treatment of chronic pain of the tongue and mouth.
PRINCIPAL PROPOSED TREATMENT: Alpha-lipoic acid
OTHER PROPOSED TREATMENTS: St. John’s wort, treatments for yeast hypersensitivity, vitamin B1, vitamin B2, vitamin B6, zinc, capsaicin, acupuncture, lifestyle changes
Introduction
Burning mouth syndrome (BMS) is a poorly understood condition in which a person experiences ongoing moderate to severe pain in the tongue, mouth, or both. Although the cause of BMS remains unclear, some patterns have become apparent to researchers. The pain generally worsens in the late afternoon and early evening but disappears at night. Most often, more than one part of the mouth is involved. Common areas of burning pain include the tongue, the hard palate (the front part of the roof of the mouth), and the lower lip. Many people recover spontaneously within six or seven years. Dry mouth and altered taste sensations often, but not always, accompany the pain.
BMS is thought to fall in the general category of neuropathic pain, which probably results from altered nerve function, possibly in the nerves carrying taste sensation. The use of drugs in the angiotensin I-converting enzyme (ACE) inhibitor family has been implicated in some cases of BMS, but the reason for this apparent connection remains unclear.
Conventional treatment for BMS consists of drugs used to treat neuropathic pain in general, including anticonvulsants, sedatives in the benzodiazepine family, and tricyclic antidepressants. There is inadequate research to determine the precise efficacy of these treatments.
Principal Proposed Treatments
The supplement alpha-lipoic acid has shown promise for the treatment of diabetic neuropathy, another form of neuropathic pain. Alpha-lipoic acid has also been studied for burning mouth syndrome, with mixed results.
In a double-blind trial, sixty people with burning mouth syndrome received either alpha-lipoic acid (200 milligrams three times daily) or a placebo for a period of months. Researchers reported that almost all persons receiving alpha-lipoic acid showed significant improvement, while none of those taking placebo improved; relative benefits endured at twelve-month follow-up. The lack of benefit seen in the placebo group is difficult to believe, raising concerns about the study’s reliability. Subsequently, two double-blind trials involving fifty-two and thirty-nine persons failed to find benefit for alpha-lipoic acid and noted a large placebo response.
Other Proposed Treatments
The yeast Candida albicans can infect the mouth, causing thrush. Thrush may cause symptoms similar to BMS. Some alternative practitioners believe that excessive Candida, or hypersensitivity to it, is the cause of many illnesses. For this reason, they recommend using antifungals to treat BMS. However, no direct evidence supports this approach, and it appears that people with BMS are no more likely to have measurable detectable Candida in the mouth than people without BMS.
Inconsistent evidence suggests that people with BMS might have deficiencies in various nutrients, such as vitamins B1, B2, and B6, and zinc. However, no evidence exists to show that supplementation with these nutrients will affect BMS symptoms. Also, a placebo-controlled trial involving thirty-nine persons failed to show any significant benefit for twelve weeks of treatment with Hypericum perforatum extract (St. John’s wort).
Chili peppers contain capsaicin, which may desensitize nerve endings and temporarily relieve mouth pain. Acupuncture, relaxation techniques such as yoga and meditation, and hypnosis are also alternative treatments suggested for BMS. Other advice includes staying hydrated and as relaxed as possible. Oral hygiene and stress management can be key in treating BMS. Tobacco products, alcohol, spicy foods, mint, cinnamon, and acidic foods should be avoided.
Herbs and Supplements to Avoid
Numerous herbs and supplements may interact adversely with drugs used to treat burning mouth syndrome, so one should be cautious when considering the use of herbs and supplements.
Bibliography
"Burning Mouth Syndrome." Mayo Clinic, 22 Feb. 2023, www.mayoclinic.org/diseases-conditions/burning-mouth-syndrome/diagnosis-treatment/drc-20350917. Accessed 15 Aug. 2023.
"Burning Mouth Syndrome." National Institute of Dental and Craniofacial Research, www.nidcr.nih.gov/health-info/burning-mouth. Accessed 7 Sept. 2024.
Carbone, M., et al. "Lack of Efficacy of Alpha-Lipoic Acid in Burning Mouth Syndrome." European Journal of Pain, vol. 13, May 2009, pp. 492-496.
"Is There Natural Relief for Burning Mouth Syndrome Sufferers?" USC Online Dental Programs, ostrowonline.usc.edu/what-is-burning-mouth-syndrome. Accessed 7 Sept. 2024.
Lopez-Jornet, P., F. Camacho-Alonso, and S. Leon-Espinosa. "Efficacy of Alpha Lipoic Acid in Burning Mouth Syndrome." Journal of Oral Rehabilitation, vol. 36, 2008, pp. 52-57.
Sardella, A., et al. "Hypericum Perforatum Extract in Burning Mouth Syndrome." Journal of Oral Pathology and Medicine, vol. 37, 2008, pp. 395-401.
Tan, Huann Lan, et al. "A Systematic Review of Treatment for Patients with Burning Mouth Syndrome." Cephalalgia: An International Journal of Headache, vol. 42, no. 2, 2022, pp. 128-161, doi:10.1177/03331024211036152.