The Puzzle of Orofacial Pain

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The Puzzle of Orofacial Pain

Burning Mouth Syndrome

Zakrzewska J, Renton T

Türp JC, Sommer C, Hugger A (eds): The Puzzle of Orofacial Pain. Integrating Research into Clinical Management. Pain Headache. Basel, Karger, 2007, vol 15, pp 165-186 (DOI: 10.1159/000101973)

Abstract:
Burning mouth syndrome (BMS) is defined as intra-oral burning sensation for which no medical or dental causes can be found and in which the oral mucosa is of grossly normal appearance. It varies in prevalence from 0.7 to 15%, depending on the diagnostic criteria used, and it is found most commonly in female menopausal women. There is increasing evidence to show that BMS is primarily a neuropathic pain with secondary psychological features. Therefore, sensory testing may be crucial in the diagnostic process. Management remains difficult due to the lack of high-quality randomized controlled trials but should take a biopsychosocial approach. There is a regularly updated Cochrane systematic review on this topic. Topical therapies such as clonazepam may be beneficial. There is some evidence for the use of vitamins, such as agr-lipoic acid, and antidepressants for longer-term use. Cognitive behaviour therapy may be beneficial. Essential for improved quality of life is reassurance that this is not a rare condition and does not lead to cancer. As this is a long-term condition, patients need to develop coping strategies.


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