US6 Burning mouth syndrome

Burning mouth syndrome (BMS) is an idiopathic burning discomfort or pain affecting people with clinically normal oral mucosa in whom a medical or dental cause has been excluded. Associated symptoms include altered taste and a sensation of oral dryness. Terms previously used to describe BMS include glossodynia, glossopyrosis, stomatodynia, stomatopyrosis, sore tongue, and oral dysaesthesia. BMS mainly affects women particularly after the menopause, when its prevalence may be 18–33%. Suggested causal factors include hormonal disturbances associated with the menopause and psychogenic factors (including anxiety, depression, stress, life events, personality disorders, and cancer phobia). There is increasing evidence that a sensory neuropathy underlies BMS symptoms. Management of the symptoms of BMS can be challenging. It has been hampered by a relative lack of high quality evidence and randomised controlled trials into BMS treatment. Many studies have not differentiated between those with burning mouth syndrome (i.e. idiopathic disease) from those with other conditions (such as haematinic deficiencies) causing symptoms of a burning mouth, making results unreliable. Local and systemic factors (such as mucosal disorders, allergies, ill fitting dentures, hypersensitivity reactions and vitamin deficiencies) may cause the symptom of burning mouth and should be excluded before reaching the diagnosis of BMS. Various interventions have been proposed to be beneficial in managing BMS ranging from cognitive behaviour therapy, antidepressants, dietary supplements, hormone replacement in postmenopausal women, topical benzydamine hydrochloride, capsaician and clonazepam. This presentation will critically review BMS diagnosis, the evidence concerning the efficacy of potential interventions and propose a management protocol.