More than 1 million adults in the United States, mostly women in their postmenopausal years, are affected by a poorly understood and difficult-to-diagnose condition known as burning mouth syndrome (BMS).

The chronic disorder is characterized by pain and a burning sensation in the lips, palate and tongue. It is sometimes accompanied by dry mouth, thirst, altered taste perception, changes in eating habits, irritability, depression and reduced desire to socialize and interact with others.

"People who have this condition are often very frustrated and in pain," says Academy of General Dentistry spokesperson Trey Petty, DDS, FAGD.

Dr. Petty says the first goal in treatment of BMS is to make sure the symptoms are not due to a larger condition, such as anemia, leukemia, severe vitamin deficiency, undiagnosed diabetes or a fungal infection of the mouth. But these causes account for only 20 to 30 percent of those affected, says Dr. Petty.

In 70 percent of those affected with BMS, in which a cause cannot be established, a dentist can help. First, the dentist may recommend chewing gum, sugarless mints or frequent drinks of water to relieve the discomfort of dry mouth. Second, antifungal medications sometimes provide relief, even when there are no visible signs of a yeast infection in the mouth.

"We've found that topical anesthetics don't help much," Dr. Petty says. "But we've found that getting people to use capsaicin, the natural chemical in cayenne pepper, often does help. Patients can have a pharmacy make up lozenges containing it, or it is available in a prescription cream."

Patients use the cream on the tongue or under the denture. While it may be uncomfortable for the first couple of days, it often is found effective with continued use. Some experts think the chemical simply distracts the patient's attention from the original pain, while others believe it actually alters the nerves sufficiently to decrease pain perception.

Other medications used to treat the disorder include antibacterials, analgesics, vitamin and mineral replacements, benzodiazepines, antihistamines and antidepressants. It is also thought that hormonal replacement may be another option.

Despite the mystery surrounding BMS, individuals with even minor symptoms should seek treatment to ensure that it is not a sign of a more serious condition.