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Professor of Oral Surgery, King's College London; Honorary Consultant in Oral Surgery, King's College Hospital NHS Foundation Trust and Guy's and St Thomas' NHS Foundation Trust, London
Burning mouth syndrome (BMS) is a rare but impactful condition affecting mainly post-menopausal women resulting in constant pain and significant difficulty with eating, drinking and daily function. The aetiology of BMS remains an enigma. Recent evidence suggests it likely to be neuropathic in origin, the cause of which remains unknown. There is no cure for this condition and the unfortunate patients remain managed on a variety of neuropathic pain medication, salivary substitutes and other non-medical interventions that help the patient ‘get through the day’. Some simple strategies can assist both clinician and patient to manage this debilitating condition.
CPD/Clinical Relevance: The dental team will recognize patients presenting with burning mouth syndrome. They are difficult patients to manage and are often referred to secondary care and, ultimately, depend on their general medical practitioners for pain management.
Article
Burning mouth syndrome (BMS) is a chronic and intractable pain condition, which predominantly affects post-menopausal women in their 5th to 7th decade. The International Association for the Study of Pain (IASP)1 has identified BMS as a ‘distinctive neuropathic entity’ characterized by bilateral burning oral mucosal pain, usually affecting the anterior two-thirds of the tongue, that may comply with the anatomy of peripheral nerves. There is a lack of any visible signs of mucosal pathology and the symptoms usually last for more than 6 months.2 The International Headache Society (IHS)3 defines BMS as ‘an intra-oral burning sensation for which no medical or dental cause can be found’. The IHS diagnostic criteria state the need for constant pain, normal appearance of the oral mucosa and exclusion of any local/systemic diseases. The pain intensity ranges from moderate to severe throughout the day, may vary during the day, and may last several years.4,5
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