Diagnostic dilemma: the enigma of an oral burning sensation

Burning mouth syndrome is an enigmatic condition that can be difficult to recognize and diagnose. Dental practitioners must be able to distinguish between primary (essential or idiopathic) and secondary burning mouth syndrome. The primary form is characterized by a burning sensation in the oral mucosa and perioral areas, typically with bilateral, symmetric distribution and an absence of relevant clinical and laboratory findings. In the secondary form, the burning sensation is due to clinical abnormalities or a systemic or psychological condition. To date, primary burning mouth syndrome has been considered a diagnosis of exclusion. A case description of a woman with oral burning sensations and the results of a retrospective case analysis are presented to aid practitioners in the understanding, recognition and diagnosis of primary burning mouth syndrome.