13.11 Burning mouth syndrome (BMS)

Previously used terms:

Stomatodynia, or glossodynia when confined to the tongue.

Description:

An intraoral burning or dysaesthetic sensation, recurring daily for more than 2 hours/day over more than 3 months, without clinically evident causative lesions.

Diagnostic criteria:
  1. Oral pain1 fulfilling criteria B and C
  2. Recurring daily for >2 hours/day for >3 months
  3. Pain has both of the following characteristics:
      1. burning quality2
      2. felt superficially in the oral mucosa
  4. Oral mucosa is of normal appearance and clinical examination including sensory testing is normal
  5. Not better accounted for by another ICHD-3 diagnosis.
Notes:
  1. The pain is usually bilateral; the most common site is the tip of the tongue.
  2. Pain intensity fluctuates.
Comments:

Subjective dryness of the mouth, dysaesthesia and altered taste may be present.

There is a high menopausal female prevalence, and some studies show comorbid psychosocial and psychiatric disorders. Laboratory investigations and brain imaging have indicated changes in central and peripheral nervous systems.

Whether secondary burning mouth syndrome attributed to a local (candidiasis, lichen planus, hyposalivation) or systemic disorder (medication induced, anaemia, deficiencies of vitamin B12 or folic acid, Sjögren’s syndrome, diabetes) should be considered as an entity is a matter for debate. Current evidence does not justify inclusion even in the Appendix.