[Burning-mouth syndrome: consideration of maintenance factors]

Burning-mouth syndrome is characterised by a number of complaints of which the burning sensation in the mouth is the most important but cannot be explained by known medical causes. Although psychological factors can predispose for or trigger physical symptoms without a medical explanation, treatment directed at the proposed psychological causes has not proven to be very effective and is not acceptable for most patients. Treatment directed at reducing the consequences of the complaint that could play a role in maintaining the problem is, however, effective and is accepted by almost all patients. Consequences that could maintain the burning-mouth syndrome are anxiety, depression, selective attention, and measures taken to find relief but which can irritate the oral mucosa. The treating physician should inform the patient and help him to change his behaviour. If patients have become depressed or very anxious as a consequence of the complaints they should be referred to a cognitive-behaviour therapist specialised in the treatment of patients with physical symptoms without a medical explanation.