Face / Head / Neck

Burning Mouth Syndrome

Definition

Burning mouth syndrome (BMS) is an extremely rare and very unpleasant pain disorder mostly occurring in women aged over 50 years, and is characterised by a burning pain in the oral cavity, even though no abnormalities are found in the mouth.

Aetiology

The cause of burning mouth syndrome is unknown, although there is some evidence to suggest a possible neuropathic pain involving small fibre neuropathy.

Signs and symptoms

Patients complain of a continuous burning pain in their mouth and tongue, the front part of their palate and, to a lesser extent, the insides of their cheeks. Patients with the syndrome often also complain of a dry mouth and changed sense of taste. The prognosis is unknown, but the complaints may last for years, although they may also decrease spontaneously.

Diagnostics

Physical Examination

A well-performed and careful examination of the oral cavity is mandatory.

In case of burning sensations and abnormalities of the oral cavity and tongue, infections such as Candidiasis, Lingua Geographica, Stomatitis and other mucocutaneous abnormalities have to be excluded. Moreover, BMS is described in relation to diabetes.

Additional Somatic Diagnostics

  • none

Additional Psycho-cognitive Diagnostics

  • RAND-36 (quality of life)
  • VAS-Pain (maximal, minimal, actual, average/week)
  • PCS (catastrophising)
  • HADS (fear and depression)

Multidisciplinary Treatment

Whether or not somatic treatment is indicated is based on the pain diagnosis.  Based on the findings of the pain questionnaires, additional diagnostics and/or multidisciplinary treatment comprising various non-somatic treatments may be necessary.

Non-somatic Treatment

Somatic Treatment

Pharmacological treatment:

  • Tricyclische antidepressiva
  • Anticonvulsiva: carbamazepine, oxcarbazepine, gabapentine en pregabaline.
  • local capsaicine