Burning mouth syndrome misdiagnosis

New research urges more rigorous standards when diagnosing burning mouth syndrome

According to new research by the School of Dental Medicine at Case Western Reserve University, not all burning mouths are the result of a medical condition known as ‘burning mouth syndrome’ (BMS) and dental professionals need better standards for an appropriate diagnosis.

The Oral Health Foundation says ‘Burning Mouth Syndrome (BMS) is a hot feeling or sensation which can affect your tongue, lips, palate, or areas all over your mouth and is often referred to as ‘glossodynia’.

‘You get this feeling when there are changes in the way the nerves in your mouth send messages to your brain – for example, about taste and temperature.

When your brain doesn’t understand these messages properly it can cause the feeling of pain or burning.

‘Diagnosis is difficult’

But because other conditions have similar symptoms, diagnosing BMS can be difficult, said Milda Chmieliauskaite, a researcher and assistant professor of oral and maxillofacial medicine at the dental school.

She explains: ‘The issues with misdiagnosis, depend to some extent on the context, but include resources, money and patient discomfort.’

‘So if a patient is misdiagnosed with burning mouth syndrome, but actually suffers from burning due to dry mouth, the patient will receive treatment for the wrong condition and the symptoms of burning will not improve.

“Often, these patients see several providers—taking up a lot of health-care resources—before they find out what’s going.’

She says this is because many dentists and clinicians aren’t trained well on the topic.

The current method for making a diagnosis is ruling out other disorders.

So treating BMS should be approached with caution, said Chmieliauskaite, who co-authored research recently published by Oral Diseases as part of the World Workshop on Oral Medicine VII.

‘A lot of the other things that cause burning in the mouth (such as diabetes, anaemia and dry mouth) can be easily treated,’ says Chmieliauskaite.

The specific cause of BMS is uncertain, she explains, but some evidence shows that it may be related to nerve dysfunction.

Sometimes, chewing gum or eating certain foods lessens pain symptoms.

Chmieliauskaite said BMS clinical trials need more rigorous standards.

‘We need a consensus for a single definition of BMS that includes specific inclusion and exclusion criteria.

‘This will help us in moving the field forward in understanding of the actual disease.’


School of Dental Medicine at Case Western Reserve University


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