Burning mouth syndrome: a systematic review of treatments

Oral Dis. 2018 Apr;24(3):325-334. doi: 10.1111/odi.12660. Epub 2017 Mar 30.

Abstract

Burning mouth syndrome (BMS) is a chronic oral pain syndrome that primarily affects peri- and postmenopausal women. It is characterized by oral mucosal burning and may be associated with dysgeusia, paresthesia, dysesthesia, and xerostomia. The etiology of the disease process is unknown, but is thought to be neuropathic in origin. The goal of this systematic review was to assess the efficacy of the various treatments for BMS. Literature searches were conducted through PubMed, Web of Science, and Cochrane Library databases, which identified 22 randomized controlled trials. Eight studies examined alpha-lipoic acid (ALA), three clonazepam, three psychotherapy, and two capsaicin, which all showed modest evidence of potentially decreasing pain/burning. Gabapentin was seen in one study to work alone and synergistically with ALA. Other treatments included vitamins, benzydamine hydrochloride, bupivacaine, Catuama, olive oil, trazodone, urea, and Hypericum perforatum. Of these other treatments, Catuama and bupivacaine were the only ones with significant positive results in symptom improvement. ALA, topical clonazepam, gabapentin, and psychotherapy may provide modest relief of pain in BMS. Gabapentin may also boost the effect of ALA. Capsaicin is limited by its side effects. Catuama showed potential for benefit. Future studies with standardized methodology and outcomes containing more patients are needed.

Keywords: burning mouth syndrome; burning tongue; glossalgia; glossodynia; oral pain; systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Amines / therapeutic use
  • Analgesics / therapeutic use
  • Antioxidants / therapeutic use*
  • Burning Mouth Syndrome / drug therapy*
  • Burning Mouth Syndrome / therapy
  • Capsaicin / therapeutic use
  • Clonazepam / therapeutic use*
  • Cyclohexanecarboxylic Acids / therapeutic use
  • GABA Modulators / therapeutic use*
  • Gabapentin
  • Humans
  • Pain Measurement
  • Psychotherapy
  • Sensory System Agents / therapeutic use
  • Thioctic Acid / therapeutic use*
  • gamma-Aminobutyric Acid / therapeutic use

Substances

  • Amines
  • Analgesics
  • Antioxidants
  • Cyclohexanecarboxylic Acids
  • GABA Modulators
  • Sensory System Agents
  • gamma-Aminobutyric Acid
  • Clonazepam
  • Gabapentin
  • Thioctic Acid
  • Capsaicin