A New Approach to a Successful Management of Burning Mouth Syndrome

Background: The accurate treatment of burning mouth syndrome (BMS) can be achieved just when the cause is properly identified. This study had been conducted to find out the relationship between symptoms and the causative factor(s) of the disease, so that to make successful treatment more easily reachable. Method: The study was conducted with informed consent on 124 patients (63 females and 61 males, ages ranging from 39 to 66) complaining of burning mouth syndrome visited the Oral Medicine Clinic in Dentistry College/ Muthanna University and referred by dentists to private clinic for consultation from January 2014 to November 2016. Medical and social history was taken from each patient, haematological investigations and measurement of stimulated salivary flow rate were done for all patients. Intraoral exam was done for each patient to exclude any detectable lesion. Findings were recorded and matched with symptoms for each patient. Each patient received treatment according to diagnosis of causative factor(s) and 6 months follow up was done for each patient after initiation of treatment to evaluate the outcome of treatment and to confirm the accuracy of diagnosis in case of good response to treatment for each patient. Results: Group A: no 41 subjects (33% of all groups): complained of continuous symptomatic day with asymptomatic night, examination and investigations showed that 35 of them (85.4% of group A) were complaining of chronic anxiety and menopause women, while the rest 6 were of similar symptoms but due to different causative factor(s). Group B: Symptoms for one day with asymptomatic following days was the criteria of 27 subjects (21.8% of all groups), 22 of them (81.5% of group B) were with nutritional deficiency and good results were obtained after treatment, the rest 5 were with tongue thrust habit, psychotic and sharpness. Group C: No symptoms on waking which increase throughout the day was associated with 36 subjects (29% of all groups), 30 of them (83.3%) suffer from dry mouth (diabetis, medications or age-related causes), the rest 6 patients complained of sharpness, ill fitted denture and menopause. Group D: Restricted night symptoms with inconstant day symptoms (no 20) (16.1% of all groups), of whom, 18 were associated with sharpness and bad prosthesis (90%) who showed excellent response after treatment, the rest 2 subjects complained of menopause and anxiety. Conclusion: Each causative factor of burning mouth syndrome is characterized by specific criteria of symptoms differ from symptoms caused by another factor(s) which must determine treatment methods.