DEAR DR. ROACH: I have a “burning tongue.” I’ve had it since my 40s. I’m now 84 years old. I could cook an egg on my tongue. It never goes away. I once mentioned this to my doctor, but she just shook her head and didn’t have a clue. I’m convinced I’ll never know what causes this. Any ideas? — C.B.

ANSWER: Burning mouth syndrome is the term used to describe a burning sensation in the mouth when no medical or dental cause can be identified. It is most common in women after menopause, and symptoms may be only on the tongue or even just the tip of the tongue. It sometimes is associated with a dry mouth or with abnormal taste sensation.

There are some conditions that can look like burning mouth syndrome but have known causes, such as oral herpes and aphthous ulcers, but a careful exam should find these (and 40-some years is way too long). Some nutritional deficiencies can cause these symptoms, but in your case, I am pretty certain you have the “idiopathic” (no known cause) type. Some authorities believe it is related to trigeminal neuralgia.

No treatment is effective for everyone, but a tricyclic antidepressant (such as amitriptyline, which works on pain fibers), gabapentin and pramipexole have been effective for some people. A neurologist might be a useful consultant, since your doctor was remarkably unhelpful and lacking in curiosity.

DEAR DR. ROACH: It’s that time of year again and my husband and I are having the “thermostat wars.” I’m sure we’re not the only ones! He wants to keep the house too warm, and it’s not comfortable. I’ve heard that it’s better to keep the temperature cooler and dress warmly in layers. Hope you can help us and others who are dealing with this issue. — R.C.

ANSWER: I’m not sure I can successfully negotiate an end to the “thermostat wars,” since from a health perspective, as long as the temperature is reasonable, neither a little warm nor a little cool is likely to cause harm.

My independent viewpoint is that it is easier to get comfortable wearing warm clothing if it’s cool than to be comfortable when it is too warm. You’ll also spend less on energy.

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