Burning mouth syndrome. A retrospective analysis of clinical characteristics and treatment outcomes.

Burning mouth syndrome is a condition characterized by burning sensations of the oral cavity in the absence of physical abnormalities of the mucosa or a detectable underlying medical disorder. It is a multifactorial disorder with unclear etiology, affecting predominatly middle-aged women. Multiple approaches to treatment have been described in the literature, with few controlled clinical trials regarding their efficacy. The objectives of this retrospective study were to: 1. determine the epidemiologic characteristics of BMS patients referred to an oral medicine practice; 2. determine if BMS classification correlates with response to treatment; 3. determine the efficacy of a variety of known therapies for BMS. A database was constructed from the charts of 150 consecutive patients diagnosed with BMS; and these charts were reviewed. Patients were classified according to previously published criteria for BMS. Presumed etiologies were grouped into depression/anxiety-associated; hematinic deficiencies, including iron, folate and vitamin B complex; oral habits: and idiopathic BMS. Treatment approaches were divided into seven categories: soft desensitizing appliance; tricyclic antidepressants (TCA); benzodiazepines (BZD); topical analgesics; hematinic supplements; habit awareness counseling; and multi-modal therapy (combining two or more of the above). Improvement was recorded using a zero to 100% VAS scale and classified as no relief (0%); mild (0-40%); meaningful/moderate (41-80%); and profound relief (81-100%). Burning mouth syndrome without any identifiable cause (idiopathic) was diagnosed in 33 patients (46.6%). Patients were followed up at one month (4 weeks) after the initial visit. Nine patients (12.7%) reported profound relief; 17 patients (23.9%) reported meaningful relief; 39 patients (54.9%) reported mild relief. This retrospective review showed no significant correlation between classification of BMS and response to therapy. The most effective treatment modalities were habit awareness, followed by TCAs.