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Burning mouth syndrome: updates on pathogenesis and diagnostic algorithms
Federica Canfora1, Elena Calabria2, Niccolò Giuseppe Armogida1
1Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131 Naples, Italy.
Journal of Oral & Facial Pain and Headache
|December 23, 2025
Summary
Burning Mouth Syndrome (BMS) is a challenging neuropathic pain condition. This review explores diagnostic algorithms and advanced tests to accurately identify BMS and guide effective, personalized treatment strategies.
Area of Science:
- Oral Medicine
- Neurology
- Pain Management
Background:
- Burning Mouth Syndrome (BMS) is a complex, chronic neuropathic orofacial pain disorder.
- Characterized by oral burning sensations without identifiable organic causes, BMS presents diagnostic and management challenges.
Purpose of the Study:
- To review the pathogenesis and diagnostic algorithms for Burning Mouth Syndrome (BMS).
- To highlight advancements in understanding BMS mechanisms and diagnostic strategies.
- To emphasize the importance of a comprehensive, multidisciplinary approach for accurate diagnosis and effective management.
Main Methods:
- Review of current literature on BMS pathogenesis and diagnosis.
- Analysis of diagnostic algorithms for excluding other oral burning causes.
- Discussion of supplementary tests including blood work, neurosensory and neuroradiological assessments, and psychological evaluations.
Main Results:
- Diagnostic algorithms aid in minimizing delays by systematically ruling out differential diagnoses.
- Specific tests like thrombophilic panels, Neuron-Specific Enolase, neurosensory assessments, and neuroradiological exams provide insights into neuropathic causes.
- Psychological and cognitive assessments help identify contributing factors and their impact.
Conclusions:
- A comprehensive diagnostic approach is essential for accurate BMS identification and differentiation from similar oral conditions.
- Utilizing specific diagnostic algorithms and advanced tests improves clinical outcomes.
- Tailored treatment plans based on thorough evaluation enhance the quality of life for BMS patients.
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