Burning Mouth Syndrome
by Keith A. Yount, DDS, MAGD
 The classic case of Burning Mouth Syndrome (BMS) is a constant
burning sensation in the mouth with no obvious or visual tissue changes, lesions, or
defects. BMS affects approximately 5% of the population. In 1,017 subjects, 4.6% of
patients report burning mouth.1 The most common oral location of the pain is
the tip of the tongue. The second most common presentation is a combination of the tip of
the tongue and the anterior palate. It occurs more in females than males ( in a ratio of
7:1). Most of the females are over 60 years of age in post menopause.2 Besides
burning, there is a wide array of other symptoms associated with BMS depending on the
particular pathology or circumstance such as dry mouth, metallic taste, headache, tinnitus
(ear ringing), difficult swallowing, difficult chewing, or various other symptoms. In most
cases, the pain improves as the day progresses. So, the most common presentation is
constant burning pain in the tip of the tongue in a 60-year old female with no visible
signs of abnormality and may result from several diverse pathologies that can confound
diagnosis.
The personality of this pain is “burning.” The term burning is rarely used by
patients unless the nervous system is affected. Since the “burning mouth
syndrome” (BMS) can be a pathology of the nervous system or pain reporting system; it
can mimic pathology in the structures it reports from or to; structural damage to bone,
skin, and connective tissue; along with many different systems malfunctions.
“In the mouth” directs the clinician to a specific area of the body, the
mouth, thus excluding all non-mouth pathologies. With the mouth’s complex wiring,
multiple fields of applicable science, specialized organs, and complex structures, it
leaves a lot of room for an array of pathologies. Just in the dental field alone, there
are subspecialties that encounter burning pains: dental, perio, endo, orofacial, oral
path, and oral surgery. Likewise, in the medical field, specialties encountering burning
pains include family practice, ENT, anesthesiology, allergy, gasteroentologist,
endocrinologist, nutritionist, and rheumatology. A new specialty, orofacial
pain—developed to treat the orthopedic jaw problem—is well trained at
neuropathic pains in the chewing system since some of them mimic “TMJ syndrome.”
Thus, the orofacial pain specialist can serve as a clearing house for BMS. This specialty
is ideally positioned to diagnose BMS because it is already a blend of medicine and
dentistry.
Please refer to the September 2007 issue for the complete text. In the event you need to order a back issue, please click here.
— Sep 2007
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