Oral Biosciences & Medicine
Oral Biosci Med 1 (2004), No. 1     10. Mar. 2004
Oral Biosci Med 1 (2004), No. 1  (10.03.2004)

Page 3-19

Burning Mouth Syndrome: Etiopathogenic Mechanisms, Symptomatology, Diagnosis and Therapeutic Approaches
Pedersen, Anne Marie Lynge / Smidt, Dorte / Nauntofte, Birgitte / Christiani, Camilla Jerlang / Jerlang, Birtna Bjørnsson
Burning Mouth Syndrome (BMS) is characterised by a continuous, painful burning sensation in a clinically normal appearing oral mucosa. The etiology of BMS remains unknown, although a number of local, systemic and psychological factors have been proposed as being of etiopathogenic importance. Numerous studies indicate that the pathological picture includes both somatic and psychological components. In the dental clinic, the patients' descriptions of the nature of pain and the location of the burning pain appear to be unambiguous and remarkably consistent. Several recent studies indicate that BMS is a neuropathic pain condition, but it is still uncertain whether it is a peripheral and/or a central neurogenic dysfunction. In the psychology clinic, too, BMS patients exhibit unambiguous patterns regarding their reactions to the perception of pain. The reaction is reflected in difficulties in distinguishing between the somatic pain and potential psychological phenomena originating from other life events. These difficulties make it pertinent to identify psychological aspects by a parallel psychological assessment in addition to the somatic one. BMS is an example of a chronic orofacial pain condition that creates major diagnostic and therapeutic problems in the dental clinic.
Today we know that multidisciplinary cooperation is required in this field. An interdisciplinary and transscientific pain clinic would be a relevant forum for assessment and treatment of these patients. From a scientific point of view this would enable us to achieve a greater understanding of the basic etiological mechanisms behind BMS and ultimately to achieve an evidence-based treatment approach.

Keywords: burning mouth, neuropathy, xerostomia, alexithymia, psychiatric disturbances