13.10 Burning mouth syndrome (BMS)

Previously used terms:
Stomatodynia, or glossodynia when confined to the tongue.

An intraoral burning or dysaesthetic sensation, recurring daily for more than two hours per day over more than three months, without clinically evident causative lesions.

Diagnostic criteria:
A. Oral pain fulfilling criteria B and C
B. Recurring daily for >2 hr per day for >3 months
C. Pain has both of the following characteristics:

    1. burning quality
    2. felt superficially in the oral mucosa

D. Oral mucosa is of normal appearance and clinical examination including sensory testing is normal
E. Not better accounted for by another ICHD-3 diagnosis.

The pain of 13.10 Burning mouth syndrome (BMS) is usually bilateral and its intensity fluctuates. The most common site is the tip of the tongue. 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. Recent laboratory and brain imaging investigations 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.