Oral burning symptoms and burning mouth syndrome-significance of different variables in 150 patients

It is well known that symptoms of burning in the oral tissues are concomitant to certain oral diseases. However, burning symptoms might occur when oral mucosa has clinically healthy appearance. Additionally, in some of these patients underlying local and systemic conditions which could lead to symptoms of burning might be found, such as candidal infection, xerostomia, oral galvanism, parafunctional habit such as tongue thrusting, psychological and neurological disturbances, diabetes mellitus, menopause, side effects of drug therapy and paraneoplastic syndrome. Finally, in patients where these clinical and laboratory findings are lacking, diagnosis of "true" burning mouth syndrome (BMS) is established and that all the other burning symptoms are due to a different pathologies representing with one symptom within the clinical spectrum of such a group of pathologies.

The etiology of true BMS is still poorly understood, albeit extensive literature has been published in that area of the research. Recent studies have proposed neurological background and in the small group of patients with BMS, Lauria et al. have identified trigeminal small-fiber sensory neuropathy. Bartoshuk et al. has reported that interactions between taste and oral pain are responsible for BMS and that the intensity of the peak oral pain correlated with the density of fungiform papillae. Additional problem regarding BMS is lack of universally accepted definition based on the uniform criteria and sometimes even misunderstanding in the field of its terminology as Scala et al concluded. Criteria for establishing a diagnosis of "true" BMS was presence of burning sensation on clinically healthy oral mucosa in the absence of all aforementioned known local and systemic etiological factors.