Burning mouth syndrome

Definition

Chronic burning mouth pain is chronic orofacial pain with an intraoral burning or dysaesthetic sensation that recurs for more than two hours per day on 50 % of the days over more than three months, without evident causative lesions on clinical investigation and examination. It is characterized by significant emotional distress (anxiety, anger/frustration or depressed mood) or interference with orofacial functions such as eating, yawning, speaking etc. Chronic burning mouth pain is multifactorial: biological, psychological and social factors contribute to the pain condition. The diagnosis is appropriate independently of identified biological or psychological contributors unless another diagnosis would better account for the presenting symptoms. Other chronic headache or orofacial pain diagnoses to be considered are listed under chronic secondary headache and orofacial pain. For most purposes, patients receive a diagnosis according to the phenotypes of orofacial pain that they currently present or that they have presented within the last year. Importantly, the chronic primary burning mouth pain should be distinguished from secondary burning mouth syndrome attributed to e.g. candidiasis, vitamin B12 deficiency, dry mouth etc. Furthermore, there may be two separate phentoypes with and without somatosensory disturbances. It can be difficult to separate between primary and secondary headache or orofacial pain in some cases. Each distinct type, subtype or subform of headache or orofacial pain within one patient must be separately diagnosed and coded. When a patient receives more than one diagnosis, these should be listed in the order of importance to the patient. Criteria: Criteria A-G are fulfilled: A. Chronic oral pain (persisting or recurring for more than three months) is present. B. The pain recurs daily for >2 hours on more than 50% of the days. C. The pain is of a burning quality. D. The pain is felt superficially in the oral mucosa. E. The pain is characterized by at least one of the following: E.1 significant emotional distress E.2 functional disability (in particular with orofacial function such as eating, yawning, speaking etc.) F. The oral mucosa is of normal appearance and no local or systemic causes explains the pain. G. The pain is not better accounted for by another chronic pain condition.

Inclusions

• Orodynia

Index Terms