Burning mouth syndrome

Overview

Burning mouth syndrome has limited supplement evidence, and findings vary by agent. Alpha-Lipoic Acid has been studied most often (10 trials), but results are inconsistent: several small studies found no pain reduction versus placebo, while others suggest symptom improvement in about half of participants, possibly in subsets such as those not taking certain psychiatric medicines.

St. John's Wort did not outperform placebo in one small oral trial. A flaxseed-and-chamomile mouth rinse was reported to ease burning and dryness in an uncontrolled study, so those results are uncertain. The heatmap and evidence reviews below break down each supplement's evidence.

Effect graph

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Relevant supplements

Relevant supplements sorted by DEX Score.


Alpha-Lipoic Acid	★★★★★	Low
Flaxseed	★★★★★	Low
St. John's Wort	★★★★★	Very Low / None

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Studies

Find individual evidence reviews for supplements sorted by DEX Score.

3 supplements for and rated at least stars. All purchase bands. No minimum star filter.

Alpha-Lipoic AcidView supplement →

Reconsider purchase★★★★★

How we scored this

Effect SizeLowEvidenceVery HighTrustMedium

Evidence Review

It is not clear if alpha-lipoic acid helps with burning mouth syndrome.
Several small studies found it does not reduce pain compared to placebo or other treatments.
However, some studies suggest it may improve symptoms in about half of people with the condition.
One small study showed improvement only in people who had not taken anxiety or depression medicines before.
This suggests alpha-lipoic acid might help if burning mouth is caused by stress, but not if caused by depression or certain medications.

Browse 10 studies1 meta-analysis

RCTThe efficacy of alpha-lipoic acid in the management of burning mouth syndrome: An updated systematic review of randomized controlled clinical trials2023

Systematic review of 9 burning mouth syndrome RCTs given 600-800 mg/day ALA found most studies favored ALA over placebo, though more research is needed before first-line use.

Effect: Benefit
Dose: 800 mg/day
Population: Burning mouth syndrome patients

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RCTEfficacy of alpha-lipoic acid in patients with burning mouth syndrome compared to that of placebo or other interventions: a systematic review with meta-analyses2022n=594

Meta-analysis of 9 burning mouth syndrome RCTs in 594 patients found ALA did not significantly reduce VAS pain versus placebo, though patients were more likely to report symptom improvement.

Effect: Benefit
Population: Adults
Participants: 594

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RCTCombination of alpha lipoic acid and gabapentin, its efficacy in the treatment of Burning Mouth Syndrome: a randomized, double-blind, placebo controlled trial2011n=60

RCT in 120 burning mouth syndrome patients found ALA plus gabapentin gave best pain relief, with 70% improved, outperforming either drug alone or placebo.

Effect: Benefit
Dose: 600 mg/day
Population: Burning mouth syndrome patients
Participants: 60

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RCTDifferent therapeutic strategies for burning mouth syndrome: preliminary data2010n=56

60-day RCT in 56 burning mouth syndrome patients found capsaicin, ALA, and lysozyme-lactoperoxidase all reduced symptoms more than boric acid control during treatment.

Effect: Benefit
Duration: 60 days
Population: Burning mouth syndrome patients
Participants: 56

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RCTAlpha lipoic acid in burning mouth syndrome--a randomized double-blind placebo-controlled trial2009n=38

Cross-over RCT in 38 burning mouth syndrome patients found both ALA and placebo cycles reduced burning, with no significant difference between treatments.

Effect: No Benefit
Population: Women
Participants: 38
Ages: 36–78

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RCTEfficacy of alpha lipoic acid in burning mouth syndrome: a randomized, placebo-treatment study2009n=60

8-week RCT in 60 burning mouth syndrome women given 800 mg/day ALA found no significant pain reduction versus placebo on VAS scores.

Effect: No Benefit
Duration: 8 weeks
Dose: 800 mg/day
Population: Women
Participants: 60
Avg age: ~64

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RCTLack of efficacy of alpha-lipoic acid in burning mouth syndrome: a double-blind, randomized, placebo-controlled study2009n=66

8-week double-blind RCT in 66 burning mouth syndrome patients given 400 mg ALA found about 30% response in all groups with no significant benefit of ALA over placebo on pain scales.

Effect: No Benefit
Duration: 8 weeks
Dose: 400 mg
Population: Burning mouth syndrome patients
Participants: 66
Avg age: ~67

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Open-labelBurning Mouth Syndrome: open trial of psychotherapy alone, medication with alpha-lipoic acid (thioctic acid), and combination therapy2004

Open study of 192 burning mouth syndrome patients found combination psychotherapy plus 600 mg/day ALA gave greater symptom control than either treatment alone or placebo.

Dose: 600 mg/day

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Burning mouth syndrome: the efficacy of lipoic acid on subgroups2004

Subgroup analysis over 2 months suggested ALA helped burning mouth syndrome patients without prior tranquillizer use more than those previously treated with psychotropics.

Duration: 2 months
Population: Burning mouth syndrome patients

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RCTBurning mouth syndrome (BMS): double blind controlled study of alpha-lipoic acid (thioctic acid) therapy2002n=60

Double-blind RCT in 60 burning mouth syndrome patients found alpha-lipoic acid improved symptoms versus placebo, with most gaining relief by 2 months and over 70% maintaining benefit at 1 year.

Effect: Benefit
Duration: 2 months
Population: Burning mouth syndrome patients
Participants: 60

View on PubMed

FlaxseedView supplement →

Reconsider purchase★★★★★

How we scored this

Effect SizeLowEvidenceLowTrustLow

Evidence Review

In a small study, people who rinsed their mouth several times a day for three months with a liquid made from boiled flaxseed and chamomile reported less burning and dry mouth, better saliva flow, and thinner saliva.
However, this study did not include a control group for comparison, and the mouthwash was made individually by each participant, which makes the results less certain.
It is not known if flaxseed alone would have the same effect.

Browse 1 study

Controlled trialEffect of a Homemade Salivary Substitute Prepared Using Chamomile (Matricaria chamomilla L.) Flower and Flax (Linum usitatissimum L.) Seed to Relieve Primary Burning Mouth Syndrome: A Preliminary Report2020n=40

In an open trial of 40 women over age 40 with primary burning mouth syndrome, a chamomile-and-flaxseed salivary substitute used for 3 months improved symptom intensity and salivary flow versus baseline.

Effect: Benefit
Duration: 3 months
Population: Women
Participants: 40

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St. John's WortView supplement →

Do not purchase★★★★★

How we scored this

Effect SizeVery Low / NoneEvidenceLowTrustMedium

Evidence Review

Taking St. John’s wort by mouth does not seem to help with pain from burning mouth syndrome.
One small study found that taking 300 mg three times a day for 12 weeks did not reduce pain any better than a placebo.

Browse 1 study

RCTHypericum perforatum extract in burning mouth syndrome: a randomized placebo-controlled study2008n=35

In burning mouth syndrome, a double-blind RCT found Hypericum perforatum extract reduced pain and improved quality of life versus placebo over the treatment period.

Effect: No Benefit
Duration: 12 weeks
Dose: 900 mg/day H. perforatum
Population: Patients with burning mouth syndrome
Participants: 35
Avg age: ~65

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Evidence visualised

Same ratings as above, aggregated so you can see coverage and imbalance.

Purchase-guidance distribution

How many supplements fall in each purchase band

Effect-size distribution

How large the reported benefits tend to be

Study distribution across 3 supplements for burning mouth syndrome (12 studies total).
Supplement	DEX	Studies	Meta-analyses	Share
Alpha-Lipoic Acid	★★★★★56%	10	1	83%
Flaxseed	★★★★★40%	1	0	8%
St. John's Wort	★★★★★32%	1	0	8%

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Overview

Effect graph

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Studies

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