Burning mouth syndrome.

Area of Science:

• Neurology
• Pain Medicine
• Oral Medicine

Background:

• Primary burning mouth syndrome (BMS) is a chronic neuropathic intraoral pain condition.
• It often presents without clear clinical signs of neuropathic involvement, affecting approximately 1% of the general population, primarily postmenopausal women.

Purpose of the Study:

• To review the clinical aspects, pathophysiology, diagnostic methods, and treatments for primary BMS.
• To outline future research directions for etiology, pathophysiology, and novel therapeutic strategies.

Main Methods:

• Review of existing literature on primary BMS.
• Discussion of advanced diagnostic techniques including quantitative sensory testing, neurophysiological recordings, and peripheral nerve blocks.
• Classification of BMS into peripheral or central neuropathic pain types.

Main Results:

• Most BMS patients can be classified into peripheral or central neuropathic pain types, differing in pathophysiology, treatment efficacy, and psychiatric comorbidity.
• Topical and systemic clonazepam show the best evidence for efficacy in current treatment.
• Hormonal substitution, dopaminergic medications, and neuromodulation are potential future treatments.

Conclusions:

• A novel hypothesis integrating hormonal, neuropathic, and genetic factors in primary BMS genesis is proposed.
• This framework will facilitate future research into BMS pathophysiology and risk factors.
• It will also support treatment trials tailored to individual patient profiles and subgroup clusters.