I have a weird, nearly constant burning sensation on my tongue that I first noticed around the time I turned 50. It feels like I scalded my mouth, but I didn’t. My husband thinks I’m crazy. Any advice?

It could very well be burning mouth syndrome (BMS). Our taste buds (of which we have thousands) receive information from both pain fibers and from specialized taste fibers. Nerve damage can trigger the erroneous firing of pain messages in addition to transmitting abnormal taste sensations.

This nerve damage may be due to menopause…upper respiratory tract infections…various medications…viral, bacterial or fungal infections…and recent dental procedures. However, in more than 50% of people with BMS, there is a gradual onset with no known precipitating factors.

Menopause typically occurs around your age. For unknown reasons, BMS often strikes women up to three years prior to menopause and up to 12 years after the change. Hormone therapy (which is frequently prescribed to ease hot flashes and other troublesome menopausal symptoms) does not relieve chronic BMS, probably because it cannot correct the nerve damage that has already occurred.

However, one study reported that as many as 50% of cases eventually improve or entirely go away on their own, usually within three to six years. In another study, BMS symptoms disappeared only in 3% of patients within five years of onset.

In the meantime, BMS sufferers commonly report experiencing temporary relief while eating…sipping a beverage…sucking on hard candy…or chewing gum. This stimulates saliva, which in turn causes nerve fibers to function more normally, if only for as long as there is actually something in your mouth.

Of course, you cannot eat, drink or chew gum all the time, so ideally this strategy should be used at times when your discomfort is worst. For many BMS patients, pain peaks in the late afternoon or early evening.

The types of foods, beverages and gum flavors that most effectively alleviate pain vary among individuals, so you need to experiment to find those that work for you. If you use this approach, it is important to remember that in order to protect your teeth from decay, you should choose water or another sugar-free noncarbonated beverage, sugar-free hard candy or sugar-free gum.

What to avoid: Some BMS patients report that burning pain worsens when eating hot, spicy and/or acidic foods…drinking alcohol…using mouthwash that contains alcohol…or using toothpaste that contains sodium lauryl sulfate (a surfactant) or cinnamon flavoring.