Burning mouth syndrome is a chronic pain condition characterized by a burning sensation of the oropharynx. The pathophysiology of burning mouth syndrome includes peripheral and central sensitization. Treatment is generally aimed at symptom reduction. We describe a woman in her seventh decade with burning mouth syndrome that had been refractory to treatment for nearly a decade. Low-dose naltrexone has been reported to provide analgesia in central sensitization states and was successful in reducing pain severity in our patient. We conclude that low-dose naltrexone may be a therapeutic option for patients with burning mouth syndrome who are refractory to conventional therapies. (A&A Practice. 2021;15:e01475.

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