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Burning mouth syndrome

Derek Richards
1Centre for Evidence-based Dentistry, Oxford, UK

Clinical Evidence Issue 4 Dec. 2000; p 753–757
Buchanan J, Zakrzewska J. Burning Mouth Syndrome.

This review in Clinical Evidence covers burning mouth syndrome, which has previously been described by the terms glossodynia, glossopyrosis, stomatodynia, stomatopyrosis, sore tongue and oral dysaesthesia. Burning mouth syndrome is a psychogenic or idiopathic burning discomfort or pain that affects people who have clinically-normal oral mucosa and in whom a medical or dental cause has been excluded.

Studies of people who have symptoms of burning mouth syndrome are often unreliable because burning mouth syndrome (ie. idiopathic disease) is not distinguished from other conditions, such as vitamin B deficiency. Consequently, incidence and prevalence vary according to diagnostic criteria. Reported prevalence in the general population varies from 0.7% to 15%. This mainly relates to the symptom of burning mouth rather than to burning mouth syndrome as defined above. Most studies suggest that burning mouth syndrome mainly affects women, particularly after the menopause, when its prevalence may increase to 18–33% of women.

The cause of the syndrome is unknown and the reviewers found no good aetiological studies. Possible causal factors are hormonal disturbances associated with the menopause, and psychogenic factors such as anxiety, depression, stress, life events, personality disorders and phobia of cancer. In addition, local and systemic factors such as infections, allergies, ill-fitting dentures or hypersensitivity reactions, and hormone and vitamin deficiencies, may cause the symptom of a burning mouth and should be excluded before diagnosing burning mouth syndrome.

The review found insufficient evidence about the effects of any treatment (hormone replacement therapy in postmenopausal women, vitamin B replacement or supplementation, antidepressants, benzydamine hypochloride) for people who have burning mouth syndrome. However one small randomised controlled trial found that cognitive behavioural therapy reduced symptom intensity.

Evidence-Based Dentistry
ISSN: 1462-0049
EISSN: 1476-5446
© 2009 British Dental Association