By Gary M. White, MD
Burning mouth syndrome (BMS) is a chronic condition in which the patient, most commonly a woman, experiences a burning, painful sensation of the oral mucosa and often the anterior tongue. Most patients are postmenopausal women with age of onset in the forties. One study of patients who also wore dentures failed to find a role for contact urticaria or contact dermatitis. Burning mouth syndrome only occurs in the absence of oral mucosal changes. Patients with evidence of lichen planus, candidiasis, etc., are excluded.
The patient complains of a burning, painful sensation in the mouth. The anterior 2/3 of the tongue is often involved. BMS has been divided into 3 types: 1) Develops and progresses during the day. Present daily. 2) The patient awakens with symptoms which are present daily. 3) Symptoms occur occasionally. Unusual intraoral sites may be affected. There is an increased incidence of contact allergies here.
Conditions which are commonly thought to play a role in BMS include: vitamin deficiencies (e.g., B1, B2, B6, B12, folate, and iron), candidiasis, parafunctional habits (clenching, bruxing, and tongue thrusting), menopause, peripheral nerve damage, xerostomia, denture problems, psychiatric problems, and diabetes. These conditions should be excluded as much as possible during workup.
Patients should undergo odontological and medical evaluation. If this fails, the symptoms may have a psychological origin. Cognitive therapy cured about 1/4 of patients in one study (J oral Pathol Med 1995;24;213)