Challenges of Diagnosis and Management of Burning Mouth Syndrome: A Literature Review.

Abstract

Background: Burning Mouth Syndrome (BMS) is defined as an idiopathic orofacial pain with recurrent intraoral burning. It mainly affects middle-aged women in peri- or post-menopause and the elderly, without any identifiable causative lesions and with or without somatosensory alterations. BMS has a complex pathogenesis involving psychogenic factors and deregulated peripheral and central pain, and there is no standard treatment protocol, making its diagnosis and management challenges.

Objective: This study was to carry out a review literature on BMS, addressing its identification and therapeutic possibilities.

Methods: Review articles and randomized controlled clinical studies whose full text was available, published between 2017 and 2022 in national and international journals, from PubMed and SCIELO databases, WHO manuals and books, were collected. As a search strategy, the keywords "burning mouth syndrome", "treatment" and "diagnosis" were used, totaling 42 papers. Of these, after applying the exclusion criteria, 34 articles were selected.

Results: Studies indicate that a comprehensive and thorough anamnesis is essential to exclude secondary factors leading to the correct diagnosis of BMS. In addition, a comprehensive anamnesis directs the best management considering a combination of neuropathic and palliative therapies, which aim to control, eliminate and/or minimize painful symptoms, treating the patient in an individualized way and not the disease itself, since this pathology has no cure.

Conclusion: Considering the impact of BMS on quality of life, further studies are needed to expand diagnostic and treatment strategies, aiming to complement existing pharmacological and non-pharmacological treatments, observing the influence that biopsychosocial and neurophysiological mechanisms have on this syndrome.