Exodontia.Info
Burning Mouth Syndrome
(Glossopyrosis, Glossodynia,
Stomatopyrosis, Stomatodynia &
Oral Dysæsthesia)
What is Burning Mouth Syndrome (BMS)?

The pain is typically described as burning.  It is a persistent and
unremitting soreness without aggravating/relieving factors.

It often lasts from months to years.

The intensity of the pain varies from slight to very severe.

Pain-killers seem to have little effect.

There is a bizarre pattern of pain radiation not consistent with
the anatomy of blood vessels or nerves.  There is sometimes
an associated
bitter or metallic taste or / and a dry mouth.

This is a common condition.  It is not inherited nor is it infectious.

What are its Causes?

Why BMS occurs is uncertain.

It seems to arise from a number of possible causes.

There is no visible abnormality or evidence of organic disease.  

BMS is associated with depression, anxiety or a stressful life-
situation.

Obsession with symptoms which may rule patient’s life.

Contributing factors may include:

  • Thrush infection (thought to be of minor importance)
  • Bacterial infections (some antibiotics have been reported
    to improve BMS)
  • Allergies (allergy to denture material)
  • Jaw joint problems (thought to be one of the most
    commonest causes)
  • Salivary gland dysfunction (severe dry mouth is thought to
    be a major cause)
  • Deficiencies (in Iron, Folate & vitamin B)
  • Hormonal (Diabetes Mellitus)
  • Psychological & psycho-social factors seem to play an
    important role in facial & oro-facial pain.
  • Psychogenic factors have been considered as the most
    common & major causative factors in BMS.
Last Updated 16th January 2014
Useful Websites:

Go 4 Hope - Finding Answers for Burning Mouth Syndrome

National Center for Emergency Medicine Informatics

Emedicine.com

European Association of Oral Medicine

Medscape

DermNet NZ


Useful Articles:

J Am Dent Assoc 1995.  Burning Issues in the Treatment of Burning Mouth
Syndrome - An Evidence-Based Study of the Literature.

Eastman Dental Institute for Oral Health Care Sciences.  Oral Medicine Clinic.  
Burning Mouth Syndrome, Patient Information Sheet 2003.

Cochrane Database of Systematic Reviews 2004.  Interventions for the treatment
of burning mouth syndrome.

Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005.  Vulnerability and
presenting symptoms in Burning Mouth Syndrome.

American Dental Association 2005.  Burning Mouth Syndrome.

Australian Dent J 2005.  Burning Mouth Syndrome.  An Update on Recent Findings

CDA Journal 2007.  The Burning Mouth

QJ Med 2007.  Commentary. Burning Mouth Syndrome (Stomatodynia)

Med Oral Patol Oral Cir Bucal 2007.  Pharmacological Treatment of Burning Mouth
Syndrome - A Review & Update

BMJ Clinical Evidence 2008. Burning Mouth Syndrome

Oral Maxillofacial Surg Clin N Am 2008. Burning Mouth Syndrome - Recognition,
Understanding and Management.

Med Oral Patol Oral Cir Bucal 2008.  Drug-Induced Burning Mouth Syndrome.  A
New Aetiological Diagnosis

Med Oral Patol Oral Cir Bucal 2008.  Burning Mouth Disorder (BMD) & Taste. A
Hypothesis

Cochrane Database of Systematic Reviews 2009.  Summary.  Interventions for the
treatment of burning mouth syndrome.

BJOMS 2009.  Serum Zinc Levels & Oral Dysaesthesia — Is There A Link?

Clinical Evidence 2009.  Burning Mouth Syndrome

BJOMS 2010.  Clinical study of tongue pain.  Serum zinc, vitamin B12, folic acid,
copper concentrations and systemic disease.

J Can Dent Assoc 2011.  Management of Burning Mouth Syndrome

J Can Dent Assoc 2011.  Diagnostic Dilemma: The Enigma of an Oral Burning
Sensation

J Clin Exp Dent 2012.  Burning Mouth Syndrome.  A Diagnostic & Therapeutic
Dilemma

BDJ 2012.  Randomized Trials for the Treatment of Burning Mouth Syndrome - An
Evidence-Based Review of the Literature
Burning Mouth Syndrome - Diagnosis Algorithm
The majority of BMS sufferers have experienced stressful life-events / long-term
social problems.  After
iron deficiency, depression is thought to be the next most
frequent causative factor (
depression followed by generalised anxiety &
cancerophobia).

Various attempts to classify
BMS based on cause and symptoms have been made.

In a classification by cause,
Idiopathic BMS is considered Primary BMS or True
BMS
, whereas Secondary BMS has an identifiable cause.

Another classification of
BMS is based on symptoms, stratifying cases into 3 types,
as follows:

  • Type 1 BMS:  Patients have no symptoms upon waking, with progression
    throughout the day.  Night-time symptoms are variable.  Nutritional deficiency
    and diabetes may produce a similar pattern.

  • Type 2 BMS:  Patients have continuous symptoms throughout the day and are
    frequently asymptomatic at night. This type is associated with chronic anxiety.

  • Type 3 BMS:  Patients have intermittent symptoms throughout the day and
    symptom-free days.  Food allergy is suggested as a potential mechanism.

BMS is likely more than one disease process and the cause may be multi-factorial.  
The ambiguous definition of
BMS makes evaluation of prognosis and treatment
difficult.


Who does it affect?

Middle-aged or older women are mainly affected.

Do I need any special tests?

Yes.  As BMS can be due to anæmia, this has to be checked for first however, in a
lot of cases, there is no indication of
anæmia.

How is it treated?

There is no treatment.  Sometimes treatments for thrush can ease the discomfort.  
If the
BMS is due to anæmia, then treatment of the anæmia will help; likewise, if
the
BMS is related to diabetes.

Mostly though, it is treated as an
atypical facial pain; that is, with anti-depressants
(though not at a dose where these drugs are acting as
anti-depressants).  It has
been found in small studies, that a
food supplement (alpha lipoic acid) has been
effective in treating BMS).

Patients often look for constant reassurance and treatment by different
practitioners.