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Book

Burning Mouth Syndrome

Gregory P. Bookout  1 , Megan Ladd  2 , Radley E. Short  3
In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.
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Book

Burning Mouth Syndrome

Gregory P. Bookout et al.
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Excerpt

Burning mouth syndrome (BMS) is characterized by burning pain in a normal-appearing oral mucosa lasting at least 4 to 6 months. The condition is idiopathic, and the underlying pathophysiology is not well understood. Patients with BMS commonly experience changes in gustatory function like parageusia. It is usually seen in females, typically in the peri-menopausal and post-menopausal periods. The diagnosis is made clinically after other etiologies of mouth pain and changes in gustatory sensation are ruled out. Studies have shown an association of BMS with Axis I and Axis II psychiatric disorders, psychiatric illness, structural and functional changes in the nervous system, and disruption of the circadian rhythm. Disruptions in the circadian rhythm affect pain perception and mood and can disrupt the hypothalamic-pituitary-adrenal axis.

Lamey and Lewis categorized BMS into 3 categories based on fluctuations in pain severity over 24 hours:

  1. Type 1 typically has no symptoms on waking and progressively worsens throughout the day with variable nighttime symptoms. It may be related to nutritional deficiency or endocrine conditions such as diabetes mellitus.

  2. Type 2 is associated with chronic anxiety and displays symptoms throughout the day.

  3. Type 3 displays intermittent daytime symptoms and may have periods without any symptoms. Food allergy is thought to be a potential underlying mechanism.

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Conflict of interest statement

Disclosure: Gregory Bookout declares no relevant financial relationships with ineligible companies.

Disclosure: Megan Ladd declares no relevant financial relationships with ineligible companies.

Disclosure: Radley Short declares no relevant financial relationships with ineligible companies.

References

    1. Aravindhan R, Vidyalakshmi S, Kumar MS, Satheesh C, Balasubramanium AM, Prasad VS. Burning mouth syndrome: A review on its diagnostic and therapeutic approach. J Pharm Bioallied Sci. 2014 Jul;6(Suppl 1):S21-5. - PMC - PubMed
    1. Sun A, Wu KM, Wang YP, Lin HP, Chen HM, Chiang CP. Burning mouth syndrome: a review and update. J Oral Pathol Med. 2013 Oct;42(9):649-55. - PubMed
    1. Taiminen T, Kuusalo L, Lehtinen L, Forssell H, Hagelberg N, Tenovuo O, Luutonen S, Pertovaara A, Jääskeläinen S. Psychiatric (axis I) and personality (axis II) disorders in patients with burning mouth syndrome or atypical facial pain. Scand J Pain. 2011 Oct 01;2(4):155-160. - PubMed
    1. Ritchie A, Kramer JM. Recent Advances in the Etiology and Treatment of Burning Mouth Syndrome. J Dent Res. 2018 Oct;97(11):1193-1199. - PubMed
    1. Lamey PJ. Burning mouth syndrome. Dermatol Clin. 1996 Apr;14(2):339-54. - PubMed

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