BURNING MOUTH SYNDROME

Abstract

Burning mouth syndrome (BMS) or stomatodynia is represented by the existence of burning feeling or sensation of the oral mucosa in the absence of clinically evident mucosal changes. It appears more frequently in middle-aged and elderly women and usually alters lips, the lateral borders, tip of the tongue, and both soft and hard palate. Along with the burning feeling, patients that suffer from BMS may also report constant oral pain, xerostomia, and dysgeusia. BMS can be divided into two clinical forms: primary and secondary burning mouth syndrome (PBMS and SBMS). The PBMS or idiopathic, in which no organic local/systemic causes can be established and a neuropathological cause is probable. The diagnosis of PBMS is based principally on elimination of etiological factors. The SBMS is caused by local, systemic, and/or psychological factors; therefore, its diagnosis is based on detecting the precise causative factor. When local, systemic or psychological factors are present, treatment or elimination of these causes generally results in a clinical improvement of symptoms. Vitamin, zinc, or hormone replacement therapy (HRT) has been noted to be useful for decreasing the burning sensation in some BMS patients with lack of the corresponding factor. If patients still present the symptoms after the elimination of potential causes, drug treatment must be initiated. Previous clinical trials found that drug treatment (with clonazepam, '-lipoic acid (ALA), antidepressants, and capsaicin) can relieve the pain, as well as psychotherapy who can also help eliminate the BMS symptoms.