Topical application in burning mouth syndrome

Intraoral and perioral burning sensations may be sequelae of burning mouth syndrome (BMSD) or burning mouth symptoms (BMSP), which present a diagnostic challenge. The aims of the study were to evaluate the efficacy of a topical anesthetic as a diagnostic test to differentiate BMSD from BMSP and to assess the comorbidities and responses to various pharmacologic treatments in BMSD and BMSP patients.

A total of forty-four charts of patients with burning mouth that visited the Rutgers School of Dental Medicine Orofacial Pain Clinic between January 1st, 2000 and November 1st, 2014 were retrospectively reviewed. Twenty patients were diagnosed with BMSD, and 24 patients were diagnosed with BMSP attributed to local and systemic causes. The diagnosis was determined per the guidelines of the International Association for the Study of Pain and American Academy of Orofacial Pain. The main goal of this study was to evaluate the effect of topical anesthetic medication applied to the burning site.

The percentage of change in pain reduction following topical anesthetic application in the BMSP group was significantly higher than that of the BMSD group (p < 0.05). In the BMSD group, 77% of females and 27% of males responded to clonazepam. One third of the females in the BMSP group also suffered from hypertension.

Topical anesthetics can be used as a simple, swift and efficient chair-side diagnostic tool to differentiate BMSD and BMSP. Females have a better response to clonazepam in BMSD.